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ort No. FHWA-RD-79-2 



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10VISI0NS FOR ELDERLY 

JO HANDICAPPED PEDESTRIANS 



DEPARTMENT Of 



.2. Hazards, Barriers, 
blems, and the Law 

May 1980 
Final Report 




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Document is available to the public through 
the National Technical Information Service, 
Springfield, Virginia 22161 



Prepared for 

FEDERAL HIGHWAY ADMINISTRATION 
Offices of Research & Development 
Environmental Division 
Washington, D.C. 20590 



FOREWORD 



This report describes the investigation of the problems and hazards 
experienced by elderly and handicapped pedestrians. From these 
investigations, countermeasures were developed and field tested. 
Another product of this research is a manual for "Development of 
Priority Accessible Networks," (Implementation Package, FHWA-IP-80-8). 
This manual presents design information and methodology for creating 
a barrier free pedestrian facility. 

Research in pedestrian safety is included in the Federally Coordinated 
Program of Highway Research and Development as Task 1 of Project IE, 
"Safety of Pedestrians and Abutting Property Occupants." Mr. John C. 
Fegan is the Project Manager, Office of Research, and Mr. Richard 
Richter is the Implementation Manager, Office of Development. 

Sufficient copies of this report are being distributed to provide a 
minimum of two copies to each regional office, one copy to each divi- 
sion office and one copy for each State highway agency. Direct 
distribution is being made to the division offices 





Charles F. Scheffey 
Director, Office of Research 
Federal Highway Administration 



NOTICE 

This document is disseminated under the sponsorship of the Department of 
Transportation in the interest of information exchange. The United States 
Government assumes no liability for its contents or use thereof. The 
contents of this report reflect the views of the contractor, who is 
responsible for the accuracy of the data presented herein. The contents 
do not necessarily reflect the official views or policy of the Department 
of Transportation. This report does not constitute a standard, specification, 
or regulation. 

The United States Government does not endorse products or manufacturers. 
Trade or manufacturers' names appear herein only because they are considered 
essential to the object of this document. 



fa>/i C' ReporfNc 



Technical Report Documentation Page 



^ 



FHWA-RD-79-2 



2. Government Accession No. 



3. Recipient's Catalog No. 



4. Title and Subtitle 



PROVISIONS FOR ELDERLY AND HANDICAPPED PEDESTRIANS 



5. Report Date 



May 1980 



6. Performing Organization Code 



Volume 2; Hazards, Barriers, Problems, and the 

7. Author's) 

John A. Templer 



Law 



8. Performing Organization Report No. 



9. Performing Organization Name and Address 

Georgia Institute of Technology 
College of Architecture 
Pedestrian Research Laboratory 
Atlanta, Georgia 30332 



■ ■ •■ 
TRANSPC 

C ; - A 



■ . MTOF 
iRTATION 



10. Work Unit No. (TRAIS) 

31E1032 



II. Contract or Grant No. 

DOT-FH- 11-8504 



US- 



12. Sponsoring Agency Name and Address 

Offices of Research and Development 
Federal Highway Administration 
Department of Transportation 
Washington, D.C. 20590 



LIBRARY 



13. Type of Report ond Period Covered 

Final Report 

June 1974-December 1979 



14. Sponsoring Agency Code 



15. Supplementary Notes 

FHWA Contract Manager: 



Phebe D. Howell (HRS-41) 



16. Abstract 

Ten categories of handicapped pedestrians are identified. Four of these categories 
report 71% of vehicular and non-vehicular accidents involving the target group; 
and 82% of the accidents occurred on walks/corridors, at street crossings, at 
curbs and curb ramps, and on stairs. 

A survey was conducted in 5 cities to determine tne problems experienced by elderly 
and handicapped pedestrians. A typology of barriers and problems has been generated 

A review of Federal, State and Local legislation treating accessibility is set out. 

This volume is the second in a series, and the others are: 

Short Title 

Executive Summary 

The Development and Evaluation of Countermeasures 

Development of Priority Accessible Networks 



Vol. No. 


FHWA No 


1 


79-1 


3 


79-3 


Implementation 
Package 


IP-80-8 



17. Key Words 

Pedestrians, Accidents, Handicapped, 
Elderly, Hazards, Barriers, Accessi- 
bility, Legislation 



18. Distribution Statement 

No restrictions. This document is avail- 
able to the public through the National 
Technical Information Service, Springfield, 
Virginia 22161. 



19. Security Clossif. (of this report) 

Unclassified 



20. Security Clossif. (of this page) 

Unclassified 



21. No. of Poges 

209 



22. Price 



Form DOT F 1700.7 (8-72) 



Reproduction of completed page authorized 



PROJECT TEAM 

For the Pedestrian Research Laboratory, Georgia Institute of Technology: 

John Templer, Principal Investigator 

Research Associates 

Part 1 

Michael Bronzini, Ph.D. 
Bruce McNabb, B.S.C.E. 
Paul Wright, Ph.D. 

Part 2 

Michael Jones, B. Arch. 
Elliott Pavlos, M. Arch., M.C.P. 
John Templer, Ph.D. 

With the assistance of: 

John Basmajian, M.D., School of Medicine, Emory University 

Fred Crawford, Ph.D., Center for Research in Social Change, Emory University 

S. Mitra, Ph.D., Department of Sociology, Emory University 

Part 3 

Francis A. Curtiss, M.Ed, Emory University Rehabilitation Center 

Research Assistants 

John Bangs, Erich Burkhart, Frank Eppell, Lee Goodson, Charles Hummel, Cary Kelly, 
Pam Markert, Sheila Maclntyre, Janice Nease, Aline Smith, Gary Tradewell, Ruthie 

Walters 

GENERAL ACKNOWLEDGEMENTS 

We would like to acknowledge the extradordinary assistance that we received from a 
very large number of organizations and individuals in carrying out this study. Invaluable 
assistance was afforded by members of the Federal Highway Administration, especially 
Phebe Howell, John Fegan and Shari Hornish. Special appreciation is extended to the 
following cities for their cooperation: Atlanta, GA; Athens, GA; Baltimore, MD; 
Boulder, CO; Clearwater, FL; and Sioux City, IA. 



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Introduction 1 

Part I ACCIDENTS: CAUSES AND COUNTERMEASURES 3 

Introduction .3 

A Survey of the Literature 3 

Pedestrian Accidents of the Handicapped and Elderly 4 

Conclusion 9 

Studies of Accidents Involving Elderly and Handicapped 

Pedestrians 11 

Accidents in Atlanta 11 

The Five City Accident Survey 34 

Summary of Accident Studies 41 

Part H ENVIRONMENTAL BARRIERS AND PROBLEMS 44 

Introduction 44 

Risk Population Among Pedestrians 53 

Environmental Problems for Elderly and Handicapped 

Pedestrians 66 

Part HI A SURVEY OF ENVIRONMENTAL BARRIERS LEGIS- 
LATION 102 

Introduction 102 

History 103 

Most Significant Recent Federal Laws Affecting Barrier 

Free Design • • • \ 105 

Federal Regulation and Standards • • • • 113 

State Legislation (thru July, 1975) 117 

Construction Codes and Standards 121 

The Private Sector 123 

Definitions used in Laws, Regulations, Standards and 

Resource Papers 124 

iii. 



Summary, Conclusions, Recommendations 132 

Summary of Recommendations 135 

References 138 

Appendices 149 



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Table 1 


Table 2 


Table 3 


Table 4 


Table 5 


Table 6 


Table 7 


Table 8 


Table 9 


Table 10 


Table 11 


Table 12 


Table 13 


Table 14 


Table 15 


Table 16 


Table 17 


Table 18 


Table 19 



Sources of Pedestrian Accident Reports 18 

Results of Interviews with Accident Victims 21 

Distribution of Handicapped Pedestrian Accident 

Victims That Were Interviewed 22 

Pedestrian Accidents: Causes and Counter measures 23 

Accident Reportage by Various Handicap Groups 36 

Survey of Pedestrian Accidents Involving the Elderly 

and Handicapped: 5 Cities. Total (174 Subjects) 37 

Percentage of Accidents by Type of Handicap 38 

Classification of Handicapped Groups 47 

Estimated Distribution of Risk Population by Major Groups 55 

Number per 1000 Population Corresponding to One 

and Two Disabling Conditions : 58 

Projected Age-Sex Composition of Population by 

Place of Residence: U.S. 1975. 60 

Age-Sex Specific Rates of Using Special Aids 61 

Distribution of Persons with Severe Auditory Impair- 
ment by Sex and Age and Rates per 1000 Population 62 

Number of Visually Impaired Persons (1000) with 
Both Eyes Involved by Degree of Impairment, Sex 
and Age: United States, July 1963-June 1964 64 

Estimate of Disabled Population (000) By Sex: 

United States, 1975 • 65 

Affirmative Action Provisions of the Rehabilitation 

Act of 1973, as Amended 108 

State's Laws for Design and Enforcement 118 

State Laws for Site Development, Buildings, Fixtures, 

Controls, Etc : . ..119 

State's Definitions of the Handicapped 125 



v. 



Table 20 


Table 21 


Table 22 


Table 23 


Table 24 


Table 25 


Table 26 


Table 27 


Table 28 


Table 29 


Table 30 


Table 31 


Table 32 


Table 33 


Table 34 


Table 35 



Interviewed Subjects by Subgroup: 5 Cities Total 175 

Interviewed Subjects by Subgroup: Florida/St. 

Petersburg and Tampa 176 

Interviewed Subjects by Subgroup: Illinois/Chicago 177 

Interviewed Subjects by Subgroup: California/San 

Francisco 178 

Interviewed Subjects by Subgroup: Washington/ 

Seattle 179 

Interviewed Subjects by Subgroup: Georgia/Atlanta 130 

Survey of Pedestrian Accidents Involving the Elderly 
and Handicapped: St. Petersburg/Tampa (38 Sub- 
jects) 181 

Survey of Pedestrian Accidents Involving the Elderly 

and Handicapped: Chicago (43 Subjects) 182 

Survey of Pedestrian Accidents Involving the Elderly 

and Handicapped: San Francisco (41 Subjects) 133 

Survey of Pedestrian Accidents Involving the Elderly 

and Handicapped: Seattle (36 Subjects) 184 

Survey of Pedestrian Accidents Involving the Elderly 

and Handicapped: Atlanta (16 Subjects) 185 

Distribution of Population by Sex, Place of Residence 

(Urban and Rural) and Selected Age Groups - U.S. 1970 186 

Distribution of Population in Central Cities by Sex 

and Selected Age Groups: United States, 1970 186 

Age Distribution of Population by Peg.\on, United States 1970. .187 

Percent of Population Using Special Aid by Age and 

Sex: United States, 1969 188 

Number Using Special Aids per 1000 by Race, 
Family Income, Usual Activity and Limitation of 
Activity: United States, 1969 • 189 



VI. 



Table 36 



Table 37 



Table 38 



Table 39 

Table 40 
Table 41 

Table 42 
Table 43 

Table 44 
Table 45 



Prevalence of Impairments (except Paralysis or 
Absence) of Upper Extremity and Shoulder Due to 
Injury and Number per 1000 Population by Age and 
Selected Characteristics 190 

Distribution of Population with Severe Auditory 
Impairment and of their Rates per 1000 Population 
by Race, Income, Education, Residence and Region 
Each Classified by age 191 

Number (000) of Visually Impaired Persons Aged Six 
Years and Over by Degree of Impairment According 
to Age, Income, Education, Region, Race, and 
Residence 192 

Number (000) and Rate per 1000 Persons of Visually 
Impaired Persons Six Years and Over, by Degree of 
Impairment According to Sex and Age 193 

Tracked Subjects by Subgroup: 5 Cities Total 197 

Tracked Subjects by Subgroup: Florida/St. Petersburg 

Tampa ' 198 

Tracked Subjects by Subgroup: Illinois/Chicago 199 

Tracked Subjects by Subgroup: California/San Fran- 
cisco 200 

Tracked Subjects by Subgroup: Washington/Seattle 201 

Tracked Subjects by Subgroup: Georgia/Atlanta 202 



vu. 



The pedestrian's part of the built environment has evolved without much deliberate 
attention to their needs. In fact, the pedestrian's needs are probably much less well 
understood than those of motorized transportation. As a society we have invested 
heavily in motor transportation both in terms of capital and research, and the body of 
knowledge aggregates at a substantial rate. There is no comparable rate of expansion in 
our knowledge about pedestrian needs and responses. 

Construction and maintenance regulations for motorized transportation mandate certain 
minimum standards for each mode—standards for gradients, layout and geometry, for 
flow and capacity, traffic surface, safety and comfort, and so forth. For the 
pedestrian, on the other hand, there are no similar mandates. The professional 
literature is sparce. Funded research has been minimal. To the best of our knowledge, 
only one university in the United States offers a course for credit that concentrates on 
pedestrian planning. And cities with plans for pedestrian movement are as unusual as 
cities that do not have transportation plans. The needs of the pedestrian are usually 
considered only as an adjunct to the needs of the motor vehicle. 

For some of us, the inadequacies of the pedestrian environment are inconvenient and 
sometimes hazardous. But for those who are handicapped, this same environment is as 
difficult to use as an unexplored jungle trail might be for the able-bodied; it presents a 
sequence of pitfalls, and dangers, and every now and then, progress is halted completely 
by something that bars the way as effectively as a range of mountains. 

The idea of a built environment that is free from barriers in the sense that it is 
accessible to the handicapped as well as the rest of society is now widely accepted, and 
in fact, federal and state legislation mandates accessibility. The question is, what is an 
accessible environment, and what are the special needs of the handicapped pedestrian 
(and what are these handicapping conditions)? These questions have been addressed to 
some extent in studies directed at making buildings accessible, but similar questions 
concerning the exterior environment have received little attention. For this reason, the 
Federal Highway Administration of the U.S. Department of Transportation initiated a 
research study, "Provisions for Elderly and Handicapped Pedestrians". The Pedestrian 
Research Laboratory of Georgia Institute of Technology has carried out this contract 
and the work is described in a series of technical reports. An Executive Summary of the 
whole project constitutes Volume 1. 

The report that follows is Volume 2 of the series. It is divided into three parts. Part 1 
is directed at identifying the major hazards experienced by the handicapped; the types 
of accidents that occur and what causes them, and how each of the handicapped groups 
is affected. Part 2 looks at the environmental barriers and problems. Field studies 
surveying the difficulties experienced by handicapped people are described, and a 
typology of barriers and problems is developed. Part 3 considers the federal and state 
legislation that covers access to the pedestrian environment. 

Volume 3 deals with solutions to some of these problems. It describes laboratory and 
field tests which were carried out to evaluate some proposed solutions, and some 
existing ways of overcoming barriers. Finally, the conclusions and recommendations 
from the study have been incorporated into The Implementation Package, "A Manual for 



Developing a Priority Accessible Network". This manual describes a planning process 
for systematically extending the accessible paths in an urban environment; and then 
provides recommended design solutions for many of the elements that cause difficulty 
for the handicapped pedestrian. 




part 
1 



UMUUUMMUMIUU 



introduction 

The pedestrian environment is not usually thought of as hostile (except perhaps in high 
crime areas). Most of us use corridors, sidewalks, pathways, crosswalks, parks and 
playgrounds with little thought about the potential hazards. We tend to discount the 
dangers inherent in the physical environment because they are not sufficiently obvious 
or frequent and perhaps because we accept the risks. 

Some of the hazards are well known and regularly receive publicity in the media. It is 
quite well understood that pedestrians and vehicles cannot share common pavement 
space without some serious consequences. The magnitude of this problem on the other 
hand is probably not generally known. 

There are other hazards for the pedestrian which occur with much greater frequency 
and with equally serious consequences. For example, the overwhelming majority of 
serious pedestrian accidents do not involve motor vehicles. They are falls on the level 
and falls while changing level— on steps and stairs. The falls on the level are as a result 
of slips, trips, stumbles, falling into unguarded holes, etc. The falls on stairs can be 
attributed in part to the inherent dangers presented by stairs, in part because of poorly 
designed stairs, and in part from carelessness by the stair users. 

There has been a substantial level of research activity into the nature and causes of 
pedestrian/vehicular accidents over the past few years. However, there has been little 
investigation of other types of pedestrian accidents (the exception to this is stairs which 
have received substantial attention over the past ten years). 

Most of the pedestrian accident studies have treated the whole population; however, 
recently, children have been identified as a high risk population and vehicular accidents 
in which they are involved have been investigated and counter measures developed. But 
there has been increasing evidence that the elderly and handicapped population are also 
over represented in pedestrian accidents. 



a survey of the literature 



Introduction 

Pedestrian accidents are a significant problem in contemporary urban society. The 
National Safety Council estimates that 120,000 pedestrians are struck by vehicles every 
year. And thousands of pedestrians are injured in nonvehicular accidents, most of which 
are falls. However, the absolute number of pedestrian accidents does not reveal the full 
dimensions of the problem. Consideration must also be given to the severity of these 
accidents. 

Collisions between pedestrians and vehicles inherently have serious consequences for 
the pedestrian. The National Safety Council found that collisions between pedestrians 
and vehicles result in approximately 10,500 deaths per year. In 1973, pedestrian 
fatalities accounted for over 19% of all motor vehicle deaths; local statistics confirm 



these findings. For example, inj.969 there v/ere 83 fatalities in the jurisdiction of the 
San Diego Police Department, and pedestrians were the victims in 29 of these 
fatalities. The pedestrian deaths were 41% of all traffic deaths in that year. These 
statistics lead us to conclude that the causes of pedestrian accidents need attention. 

"i A ^ R 7 8 Q 1 f) 

Studies of pedestrian accident statistics >>>>>>> reveal two important facts: 
1) the greatest number of pedestrian accidents occur to children; and 2) the most severe 
pedestrian accidents involve elderly and handicapped people. To reduce the number of 
pedestrian accidents, injuries, and deaths to a significant extent, it will be necessary to 
focus on countermeasures to protect these subgroups particularly. The survey that 
follows discusses the recent literature on the subject as a first step towards developing 
countermeasures. 

pedestrian accidents of the 
handicapped and elderly 

The first part of this section deals with studies of pedestrian accidents based on 
aggregate data, and divides the entire handicapped population into three groups: 
children, the elderly, and the handicapped. The second part examines a case study 
report about pedestrian accidents of handicapped people. 

PEDESTRIAN ACCIDENT STUDIES BASED ON AGGREGATE DATA 

Children 

Children are involved in a significant number of all pedestrian accidents. An 
examination of national accident statistics shows that over one-half of the nonfatal 
pedestrian injuries occur to children less than 16 years of age. This percentage is far 
greater than the percentage for any other age group of similar size. The large number 
of pedestrian accidents in this age group produces a low fatality rate. But while the 
fatality rate for children involved in pedestrian accidents is not high, the number of 
fatalities is still significant. In fact, traffic accidents are the leading cause of death 
for children 5 to 14 years of age. 

Causes 

Many researchers have found-.thal the primary cause of child pedestrian accidents is the 
child running into the street. ' ' ' Children are usually playing near their home 
when they suddenly dash into the path of an approaching vehicle. Blackman's conclusion 
is typical. He states, "the greatest danger to. children comes from their undisciplined, 
uncautious playful behavior near their homes." 

Many factors apparently contribute to the child's unexpected dash into the street. Fruin 
finds that "children are especially vulnerable (to pedestrian accidents) due to gaps in 
language, perception, and visual and auditory comprehension..." This indicates that 
the child's behavior is often based on a lack of understanding rather than a willful 



disobedience. Certain family and environmental factors also increase the probability of 
pedestrian accidents involving children. Comparisons between children involved in 
pedestrian accidents and children not involved in pedestrian accidents reveal several 
important findings. The children in the accident group came from homes with less 
parental supervision and fewer play facilities. These studies also showed that the local 
neighborhood of the accident victims had fewer playgrounds and less open space. 

It is significant to note that the child's trip to and from school is not a major source of 
pedestrian accidents. Statistics show that less than 10% of the child pedestrian 
accidents occur during the school trip. 

Counterm easur es 

Several interesting and innovative solutions have been proposed to reduce the number of 
pedestrian accidents involving children. The primary goal of each of these 
countermeasures is to keep the child from running into the street. It appears that the 
enforcement solution has application only in high pedestrian volume situations such as a 
school crossing. The random nature of collisions between children and vehicles makes 
strict enforcement of pedestrian laws difficult. 

A study by the Los Angeles County Road Department concluded that education was the 
most effective way to improve pedestrian safety for children. One of the most 
popular educational tools is the "Safety Town" program. It uses classroom instruction 
and actual traffic experience to accomplish the educational task. The "Safety Town" 
program has been very effective in reducing pedestrian accidents during school trips. 

12 
Additional solultions have been proposed in the engineering area. Marsden advocates 

the redeployment of street parking as a possible countermeasure. He also suggests that 

new streets be built at a slightly elevated level. He believes that an increase of six 

inches in the profile of the street and the use of a six-inch curb will reduce the number 

of dart-outs by children. A more applicable countermeasure is Blackman's suggestion 

that more off-street play facilities be provided in urban residential areas. These play 

facilities should reduce the need for children to play in or near the street. 

The Elderly 

Elderly pedestrians are also involved in a large number of pedestrian accidents. One 
obvious reason for this situation is that elderly people do more walking than middle- 
aged people. Many elderly people do not have access to an automobile. Therefore, 
unless they can use a public transit system, they must make their trips on foot. As 
Hurley and Thompson point out, "Older people are a very, mobile group; assumptions that 
they are an infirm group of little mobility are not true." 

There are a great number of theories as to why elderly people are involved in pedestrian 
accidents. Most of these theories are based on the physical or psychological 
characteristics of the elderly. Many of the characteristics are partial or total 
handicaps of one form or another. In many instances, the handicap is a result of old age 
rather than any specific accident or birth defect. 



Causes 

17 4 18 19 20 

1. Physical . Several researchers ' ' ' ' have found that poor eyesight is the 

cause of many elderly pedestrian accidents. Typical problems include: recognizing 
vehicles, reading signs, and distinguishing colors. 

Loss of hearing is also a significant problem for elderly people. The failure to 
hear a horn, a siren or other traffic noises greatly increases the possibility of a 
pedestrian accident. 

Many elderly people also have problems with simple individual movements. They 
almost never run. The dart-out type of accident is almost nonexistent among the 
senior citizens. In Tharp's study of pedestrian accidents in Houston there were 12 
accidents involving elderly people. Each of the victims was walking at the time of 
the accident. Elderly people frequently overestimate their speed of movement. 
They tend to believe that they have not slowed down since their youth. This 
overestimation is very critical when the elderly person decides to cross the street 
in front of the approaching vehicle. Additional dangers for elderly people arise 
from difficulties in stepping up and down curbs, climbing steep hills, and walking 
on uneven sidewalks. 

2. Psychological . Some elderly people are confused when they traverse the traffic 
scene. This disorientation may be caused by senility or it may be the side effects 
of medication. It is frightening to note that "of the 20 medications^ most 
frequently taken by elderly people, 12 have a sedating effect on the brain." The 
confusion experienced by elderly people may also be engendered by the lack of 
clarity of the pedestrian environment. Signs, traffic signals, turning vehicles, and 
pedestrian signals may contribute to disorientation. 

The degenerative process in the bodies of the elderly tend to slow down the 
normal mental processes. The elderly person is capable of making a deliberative 
decision such as where to cross the street. But he is no longer able to make quick 
decisions, such as when to cross, when to wait, when to stop or when to go. This 
theory is confirmed by Herm's study of pedestrian behavior in crosswalks in San 
Diego. His data shows that "people in the 65-69 year old group were involved in 
13 accidents., in marked crosswalks but showed no involvement in unmarked 
crosswalks." 

Elderly people tend to be fearful of the pedestrian environment. Some of the 
most common fears are: fear of becoming lost, fear of becoming confused, fear of 
being hit by a vehicle, fear of being attacked, and fear of turning vehicles. 
These fears make the elderly person unsure of his movement. He is frequently 
worrying about one of these fears and his concentration on the immediate 
situation is very poor. 

Weiner summarizes the causes of elderly pedestrian accidents this way: 

In summary, through life-long habits, neglect, contempt for law and particu- 
larly for automobiles, lack of understanding of traffic control devices, and 
poor sensory and motor capability, the elderly pedestrian daily faces 
unnecessary dangers. 



Countermeasures 

Several counte/measures for pedestrian accidents of the elderly population emphasize 
education. ' ' Clearly, the educational program must be sustained. Older people 
do not learn as quickly as children and they forget the lessons very rapidly without 
periodic reinforcement. Lessons that might be emphasized in an educational 

presentation for the elderly include: 

1. Facts about speed and stopping distance. 

2. Compensatory actions for failing eyesight and hearing. 

3. General pedestrian safety rules, such as where to walk and what to wear. 

Weiner disagrees with the reliance on enforcement or educational programs. He states: 

Exhortations to 'crack down' on offenders, or to show movies on safe walking 
behavior at senior n citizen clubs, or other well-meaning methods are probably 
doomed to failure. 

Weiner advocates the use oL design countermeasures. Several other researchers concur 
with this conclusion. Carp believes that "clear and unambiguous pedestrian directions 
and longer pedestrian signal intervals" would improve the pedestrian environment. 
Libow offers these possible improvements: 

1. Multiple sensory directional orientation systems. 

2. Use of striped crosswalks. 

3. Low curbs. 

4. Increased illumination of traffic lights. 

5. Pedestrian rest areas. 

Other Handicapped People 

The number of reports detailing pedestrian accidents of other types of handicapped 
people is very limited. Several reasons can be cited for this shortage. Accurate 
accident statistics are not maintained for this group of people. Even in situations where 
a handicapped person is identified, he is usually classified in the standard manner by age 
and sex. Another reason for the small number of reports is the small number of 
pedestrian accidents of these handicapped people. In many local areas, a handicapped 
pedestrian is unable to move safely about the streets by himself. This lack of mobility 
is very discouraging to the handicapped person because it removes the possibility for 
normal social interaction. However, the small number of accidents is not indicative of 
the actual number of handicapped people. 

The diverse groups of handicapped people tend to have different characteristics and 
problems. This means that the causes and countermeasures for each group are often 
dissimilar. 

Causes 

Many features of the pedestrian environment create difficulty for the Jhandicapped 
person. Some of these designs can cause pedestrian accidents. Fruin identifies 
several of these barriers: 

...steps or curbs that are too high, long flights of stairs, inaccessible elevators, 

7 



steep and narrow walks, gratings in walkways, narrow doorways, revolving doors, 
narrow aisles, and the lack of a redundant auditory system to aid visually impaired 
and partially sighted people in the use of visual aids. 

Another cause of pedestrian accidents is alcohol. Tharp's study in Houston found that 
the pedestrian had been drinking prior to the accident in almost 10 percent of the 
accidents. 

Counter measures 

Almost all of the countermeasures proposed to help the handicapped person are based on 
design modifications. Robert's survey of visually impaired and deaf people reports the 
improvements that are advocated by the handicapped people. The visually impaired 
people recommended: 

More and wider sidewalks and crosswalks, more use of pedestrian/vehicular 
separation, use of textured pavements, use of angular sidewalk corners at 
intersections, and Braille maps for directional information. 

The deaf people recommended: 

Better and clearer signing, more appropriate sign locations, audible crossing 
signals at various frequencies, more and better lighting, and the use of handrails in 
certain locations. 

It should be noted that the needs of the deaf people are less critical than those of the 
visually impaired. The major reason for this discrepancy is that deaf people are less 
limited to the pedestrian mode of travel. With special training, they are capable of 
driving an automobile. 

A counter-measure for people with walking handicaps is the modification of stair design. 
Templer 25 recommends a range of riser heights, tread depths, and other layout 
dimensions which are "safe, comfortable and convenient." 

The most appropriate countermeasure for the intempecate drinker is the enforcement of 
local laws concerning public drunkenness. Marsden recommends that all pedestrian 
accident victims be tested for the presence of alcohol and other drugs. He believes that 
this analysis would help to identify the actual problem of the drinking pedestrian. 

PEDESTRIAN ACCIDENT STUDIES BASED ON CASE STUDIES OF INDIVIDUAL 

ACCIDENTS 

The only study exclusively devoted to handicapped people is Marsden's examination of 
fatal accidents involving intoxicated pedestrians in San Diego County, California. This 
report shows that alcohol is a causal factor in many pedestrian accidents. An 
examination of accident records showed that the drinking pedestrian contributed to at 
least 25 percent of the fatal pedestrian collisions in San Diego County. 



Marsden's research focused on the case study of 50 fatalities involving intoxicated 
pedestrians. Important facts about the accidents were assembled from the coroner's 
records and police reports. The individual analysis of each accident was used to identify 
the significant causal factors and to propose appropriate counter measures. 

Causes 

The behavior of the drinking pedestrian is a major cause of accidents. Confusion and 
disorientation are very common characteristics. Marsden's study found that 60 percent 
of the accidents were of the dartout type. The pedestrian suddenly appears in the 
street away from a marked or unmarked crosswalk. The driver of the vehicle cannot 
avoid collision and the pedestrian dies as a result of the accident. 

Environmental conditions also cause many pedestrian accidents. All of the cases in 
Marsden's sUidy occurred at night, and many of them occurred where there was little or 
no lighting. Most of the accident locations were outside the major business and 
shopping areas and they did not occur near the local drinking establishments. 

Countermeasures 

The countermeasures for the reduction of accidents involving intoxicated pedestrians 
must necessarily be removed from the time and place of the accident. These accidents 
seem to occur at unpredictable hours and in unexpected locations. Of the 50 cases 
examined in Marsden's study, only two cases were located within one-half mile of each 
other. This dispersion causes isolated enforcement programs and individual design 
improvements to be relatively ineffective. 

Marsden's recommendations involve education prior to an accident and prosecution after 
an accident. His three proposals are: 

1. A modification of driver education programs to increase emphasis on pedestrian 
hazards. 

2. An intensive and realistic program for employing detoxification and rehabilitation 
centers for the treatment of acute alcoholism and problem drinking. 

3. A revision of state and local laws should place criminal responsibility upon the 
intoxicated pedestrian who is found to be the cause of a collision. 

conclusion 

Several significant conclusions regarding the causes and countermeasures of pedestrian 
accidents of elderly and handicapped people can be made at this time. These 
conclusions are based on the preceding survey of all current and available literature in 
the field. 



Causes 

The major causes of pedestrian accidents have been established by previous research. 
Certain factors may be identified with particular groups of people, such as the elderly 
or the handicapped. While national statistics produce an excellent impression of the 
scope of the pedestrian accident problem, the case study approach is much more 
successful in identifying specific causal factors. One promising method of imple- 
menting the case study approach is the interview of pedestrian accident victims. The 
Interdisciplinary Workshop on Transportation and Aging recommended this procedure in 
1970: "It would be desirable to interview the aged pedestrian involved in accidents and 
correlate design defects to accidents." 

Countermeasures 

The significant countermeasures proposed in the literature can be grouped into five 
categories: enforcement, safety campaigns, education, city planning, and physical 
design. 

Several enforcement programs have achieved good short-term success in reducing 
pedestrian accidents. However, in the long run, the enforcement countermeasures 
require large amounts of manpower and money. Most communities are unable or 
unwilling to make this type of investment. While enforcement programs will continue 
to be an appropriate counter measure for occasional implementation, they are not a 
permanent solution. 

Safety campaigns are also effective in the short run. However, their effectiveness 
frequently lasts no longer than the safety campaign. The long-rterm effects of a safety 
campaign are practically negligible. Safety campaigns are most effective when they 
are used on an annual basis, such as at the start of the school year. 

Educational countermeasures are used to instruct children in safe street 
crossings. Until the educational process can be effectively extended for 
all types of handicapped people, its value will be limited. 

Countermeasures which are based on city planning solutions are theoretically very 
effective in reducing pedestrian accidents. Proper management of land use and 
transportation facilities can produce a much safer pedestrian environment. The major 
weakness of these programs is the long time delay from theoretical conception to 
implementation of the plan. These long delays may discourage many municipal 
governments. 

The final type of countermeasure for the reduction of pedestrian accidents is the 
physical design approach. This solution is based on a principle of human factors 
engineering: 

One should design a system in such a way that errors are avoided because the 
design makes them impossible— rather than rely on conscious cooperation, 

10 



prudence, and caution of the operator. So it is with the pedestrian, particularly 
the very young and very old. 10 

While the concept of the physical design countermeasures has existed for quite a while, 
implementation has been very slow. Now is the time for the practical implementation 
and evaluation of these theoretical proposals. Marsden concurs with this opinion: 

It is, therefore, the recommendation of this investigator that subsequent research 
on pedestrian collisions confine their examination to the recommendations of the 
various studies and evaluate the effectiveness of those recommendations. 

If we wish to reduce the pedestrian accidents of elderly and handicapped people (as well 
as the pedestrian accidents of the general population), we must use design counter- 
measures to reduce the causes of these accidents and to create a safer pedestrian 
environment. This improved environment must be designed for all of the people and 
requirements of the elderly and handicapped people given particularly close scrutiny. 

studies of accidents involving elderly 
and handicapped pedestrians 

Introduction 

From the discussion thus far, it seems that there have been very few studies of the 
nature and causes of vehicular/pedestrian accidents involving the elderly and handi- 
capped and no published studies of non-vehicular accidents involving this group. While 
information on two of the subgroups of this segment of the total population, children 
and the elderly, has been the subject of some research, very little previous work has 
addressed the other handicapped groups. 

To gain a better understanding of the particular hazards facing the target groups, two 
studies were undertaken. For the first study, an accident reporting section was included 
in an unstructured survey carried out in five cities (and described in Part 2 of this 
volume, "Environmental Barriers and Problems"). This accident reporting section 
includes vehicular and non-vehicular incidents and the results of this study are described 
in this section. 

Concurrent with the Five-City Survey, a study of accidents involving elderly and 
handicapped pedestrians was carried out in Atlanta. 

accidents in Atlanta 

The objectives of the Atlanta accident study was to enlarge our understanding of the 
nature and causes of pedestrian accidents in which elderly and handicapped people are 
involved, and then to suggest some appropriate countermeasures. Specifically, the aim 
was to identify what types of accidents the target group experienced, and to what 

11 



extent these accident types differ from or are similar to those experienced by the rest 
of the population. This entailed developing a method for identifying accidents in which 
pedestrians were involved; eliminating those cases which did not involve elderly and 
handicapped people; investigating the remaining cases to try to establish what type of 
accident occurred and what were the causes; comparing the results with those from 
previous accident studies of the general population; and, finally, developing some 
testable hypotheses for counter measures that may reduce the accident rate. 

The scope of the study was limited in time, eight months from start to finish. And for 
similar reasons, it was limited to the Atlanta metropolitan area. These two limitations 
and the inevitable cost constraints limited the data that could be examined in practice, 
and therefore the usefulness of the results. Nevertheless, the results, and those of the 
Five-City Accident Survey described in the next section, provide strong indications of 
the particular hazards that are typically experienced by elderly and handicapped 
pedestrians. 

Procedures 

The Atlanta accident study was carried out in four phases: 

• Phase 1 . Identification of pedestrian accidents involving the elderly and 
handicapped. 

• Phase 2 . Interviews conducted to try to establish the facts relating to the 
accidents. 

• Phase 3 . Conducting field evaluations of the accident sites. 

• Phase 4 . Evaluating the data and drawing conclusions. 
The remainder of this chapter follows this sequence. 

Phase 1: Identification of Pedestrian Accidents Involving Elderly and Handicapped 
Pedestrians . 

Several sources of information on pedestrian accidents were investigated—police 
records, ambulance records, insurance records, and hospital emergency room records. 
Two of these sources were quickly rejected. Insurance companies were reluctant to 
participate. And the ambulance system in the Atlanta metropolitan area did not keep 
records that were useful for the study. The police records, as discussed later, were 
adequate, but seldom included reports on nonvehicular accidents. The hospital 
emergency room data required special procedures in order to collect the data, but the 
data were quite substantial and included all kinds of pedestrian accidents. However, the 
data was not kept in a central file like the police records; the data was available in each 
of the many metropolitan Atlanta hospital emergency rooms. For these reasons it was 
decided to make use of the police records and to gather data from two Atlanta hospitals 
that agreed to participate— Grady Memorial Hospital and Piedmont Hospital. 



12 



Atlanta Police Department 

The initial source for pedestrian accident reports was the 1973 file of vehicular traffic 
accidents in the Traffic Division of the Atlanta Police Department. This file was used 
because it was the largest available source of serious pedestrian accidents in the city. 
The 1973 vehicular accident file contained reports of approximately 20,000 traffic 
accidents in the City of Atlanta. 

Selection . An inspection of the vehicular accident file was made in August, 1974. Each 
of the police reports was inspected for any type of pedestrian involvement. A thorough 
survey of the file revealed that pedestrians were involved in only 538 of the 20,000 
accidents. The elimination of 17 reports of pedestrian accident victims living outside 
the metropolitan Atlanta area reduced the number of applicable accident reports to 
521. The decision to disregard the accidents of the out-of-town people was based on the 
anticipated difficulty in conducting telephone interviews and the victim's probable 
unfamiliarity with the accident site. 

Information Collected . The collection of information about the pedestrian accidents 
presented some difficulty. Due to police department regulations it was not possible to 
remove the accident reports from the police station for photocopying. Nor was it 
possible to photocopy the accident reports at the police station. Therefore, the 
information from the police files had to be manually copied. The following information 
was copied from each of the 521 police reports: the location of the accident, and the 
victim's name, age, address, and sex. 

Location of Victims . Using the information from the police files, the researchers 
attempted to locate each of the 521 pedestrian accident victims for a telephone 
interview. Unfortunately, the police reports did not contain the individual's telephone 
number. Therefore, additional information sources had to be used. The telephone 
numbers for many of the accident victims were located in the 1973 Atlanta City 
Directory and the 1974 Atlanta Suburban Directory. Additional information was 
obtained from the 1973 and 1974 Telephone Directories for Greater Atlanta. 

Possible telephone numbers were found for only 296 of the 521 pedestrian accident 
victims. These 296 usable reports were classified into three groups according to the age 
of the accident victim. Victims less than 18 years old were classified as children. 
Victims over the age of 65 were classified as elderly. The remaining accident victims 
were classified as middle-aged. These classifications were directly related to the 
definition and identification of handicapped people as discussed earlier. A list of the 
296 pedestrian accident victims, their telephone numbers, and all other appropriate 
information was forwarded to the people hired as interviewers for Phase 2. 

Grady Hospital 

The second source of pedestrian accident reports was the file of hospital records from 
the Surgical Emergency Clinic of Grady Memorial Hospital. This hospital receives many 
of its cases from the central city area of Atlanta. It was expected that this current 
accident information would produce a high percentage of completed interviews. An 

13 



improvement of this type could increase the efficiency of the entire data collection 
process. 

The pedestrian accident information was obtained through the Administration Office of 
Ambulatory Care at Grady from December, 1974 through April, 1975. Approximately 
32,000 hospital records were filed in the Surgery Emergency Clinic during this period. 

Selection . The selection of pedestrian accidents from the hospital records was made on 
a regular basis during the study period. While the researchers provided substantial 
guidance concerning the definition of a pedestrian accident, the final selection was 
made by hospital personnel. This selection process disregarded pedestrian accident 
victims living outside metropolitan Atlanta. Pedestrian accident reports which listed no 
name or no phone number were also disregarded. A total of 153 pedestrian accident 
reports were selected from the 32,000 hospital records. 

Information Collected . The public information copy of the hospital record provided all 
of the facts for the pedestrian accident report. This information included: how the 
accident occurred, the type of injury, and the victim's name, address, age, sex and 
telephone number. 

The reports of the 153 pedestrian accidents were classified according to the age of the 
victim. Three groups were formulated. These groups were identical to those used for 
the accident reports from the Atlanta Police Department file. 

All of the available information about each pedestrian accident victim was placed on 
the first page of an individual interview form. An example of this form is shown in 
Appendix A. The 153 pedestrian accident interview forms were distributed to the 
interviewers at the earliest opportunity. 

Piedmont Hospital 

In order to broaden the scope of the project beyond the pedestrian-vehicle collisions 
found in the Atlanta Police Department file, another hospital was selected as the third 
source of pedestrian accident reports. Piedmont Hospital in the near northside area of 
Atlanta was selected for this purpose. In contrast to Grady Memorial Hospital, 
Piedmont Hospital primarily serves the residents of the near northside area. 

The source of pedestrian accident reports at Piedmont Hospital was the file of hospital 
admission records in the emergency room from December, 1974-April, 1975. There 
were approximately 10,000 admissions filed during this 18-week period. 

Selection . Possible pedestrian accidents were selected from the hospital files by the 
clerical personnel in the emergency room. The researchers provided substantial 
guidance to these hospital personnel concerning the definition of a pedestrian accident. 
However, the emergency room personnel made the final selection. 

Pedestrian accidents were a small part of all emergency room admissions at Piedmont. 
The possible pedestrian accident population was further reduced by the elimination of 

14 



all possible pedestrian accident victims residing outside metropolitan Atlanta. All 
pedestrian accident reports which failed to list the victim's name or telephone number 
were also disregarded. All of these constraints reduced the number of possible 
pedestrian accident reports to 540. 

Information Collected . The following information was furnished to the researchers by 
the hospital personnel: how the accident occurred, the type of injury, and the victim's 
name, address, age, sex and telephone number. It should be noted that the researchers 
never saw the actual hospital admission record. 

Each of the 540 possible pedestrian accident reports was categorized according to the 
age of the victim.The classifications were identical to those used for the Atlanta 
Police Department accidents. All of the available information about each of the 540 
possible pedestrian accident victims was placed on the first page of the standard 
interview form. These forms were forwarded to the interviewers at the first 
opportunity. 

Additional Sources 

Consideration was given to one additional source of pedestrian accident information. In 
October, 1974, the researchers inspected the 1973 General File of the Records Division 
of the Atlanta Police Department. This file contained approximately 20,000 reports 
which could not be assigned to an appropriate section of the Atlanta Police Department 
(traffic, vice, homicide, etc.). Administrative personnel, familiar with the General File, 
estimated that the File would contain 15 pedestrian accidents. The researchers judged 
the inspection of the General File to be unworthy of further consideration. 

Phase 2: Interviews Conducted to Try to Establish the Facts Relating to the Accidents 

A total of 989 possible pedestrian accident reports were submitted to the interviewers. 
Each report was transmitted to the interviewers as soon as it was processed. This was 
done in order to minimize the delay from the time of the accident to the completion of 
the interview and therefore to produce an accurate account of the accident. All of the 
interviews were made by telephone between December, 1974 and August, 1975. 
Telephone interviews were judged to be the fastest way to contact the greatest number 
of people. 

Purpose 

There were three reasons for interviewing the possible pedestrian accident victims: 

1. To identify the nature of the handicap of the pedestrian accident victims. 

2. To acquire all of the pertinent information about the accident. 

3. To obtain the victim's opinion of the cause of the accident. 

Some of this information was available on selected police reports but none of these 
facts were found on the hospital records. 

15 



The Interviews 

While most of the interviewers retained for this project were experienced in this type of 
work, specific instructions and training were necessary. The interviewers were 
instructed to eliminate the nonhandicapped and nonpedestrian accident victims from 
further consideration. 

An example of the interview form is shown in Appendix A. This form was developed by 
the researchers specifically for the telephone survey. Each of the questions is directly 
related to one of the aforementioned interview purposes. However, the questionnaire 
was intended to provide an informal guide for the interviewer. It was not intended to be 
a structured fixed question format. The interviewers were encouraged to conduct each 
interview in the most convenient and efficient way. 

Complete interviews were received for 105 of the 989 possible pedestrian accident 
victims. 

Phase 3; Conducting Field Evaluations of the Accident Sites 

Engineering field studies were made for some of the accident sites identified in the 
interviews of handicapped pedestrian accident victims. The purpose of these field 
studies was to identify and describe the specific cause of each pedestrian accident. 
Emphasis was placed on the measurement of the physical features in the pedestrian 
environment at each accident site. 

Selection 

It was not possible to investigate each of the 105 accident sites in the time allotted for 
this portion of the study. Therefore a selection system was established to use the 
available field study period in the most efficient and productive way. This system 
involved the elimination of several categories of pedestrian accidents from considera- 
tion for field studies. 

These categories were: 

1. Accidents which occurred at imprecise locations. 

2. Accidents which occurred inside buildings. 

3. Accidents which occurred on private residential property. 

The elimination of these categories reduced the number of handicapped pedestrian 
accident reports available for field study to 53. 

Preparation 

The interview with each pedestrian accident victim was carefully reviewed prior to the 
inspection of the accident location. In the case of the pedestrian accidents reports 
derived from the Traffic Division of the Atlanta Police Department, additional 

16 



information about each field study was collected from the original police report. A 
convenient checkoff form, shown in Appendix A, was used for this task. Police reports 
were not available for all of the pedestrian accident reports from the hospital sources. 
Consequently, the police reports were not considered for any of the hospital cases. 

On the basis of the completed interview forms and the available police reports, a field 
study report form was developed. An example of this two-page form is shown in 
Appendix A. 

All field study sites were plotted on a large map of Atlanta. Accident locations in the 
central business district were plotted on a separate map. These procedures enabled the 
researchers to group adjacent accident sites for individual field trips. The location of 
each group of accident sites was transferred to a portable map for the daily field 
studies. This process increased the efficiency of the field studies. 

Implementation 

The actual investigations of the accident sites were made in July and August, 1975. A 
total of 45 accident locations were examined. Standard surveying equipment was used 
for the field measurements. A Rolatape model 180T was used for longer distances. 
Photographs were taken with a Grafic 35 mm camera and a Kodak 126 Instamatic 
camera. 

Review 

Each completed field report was checked for accuracy and clarity. Questionable 
descriptions or comments were reviewed with the field investigation team and the 
accident sites were reinspected, if necessary. The condition diagram and the collision 
diagram from the field report were redrawn at an appropriate scale by the surveyors. 

Phase 4: Evaluating the Data and Drawing Conclusions 

An evaluation was made of all accident reports which contained interviews with 
handicapped victims. The evaluation included field study cases and nonfield study 
cases. The researchers completed each evaluation with the full knowledge of all 
available information. Photographic slides, field reports, interview reports and police 
reports were considered in the evaluation process. 

On the basis of this evaluation the researchers identified and recorded the specific 
causes and suggested countermeasures of each accident. Next, the specific causes were 
summarized and categorized into general causes. General countermeasures, based on 
the specific countermeasures and the general causes, were also identified and noted. 
The complete discussion of these results follows. 

Results and Discussion of Results 

The results are separated into two major sections: (A) preliminary results and (B) final 

17 



results. To facilitate comprehension, the objective results and the subjective analysis 
of the results for each part of the project are presented concurrently. 

A. Preliminary Results: 

The preliminary results are the findings from Phases 1 and 2. First, from Phase 1, the 
three sources of pedestrian accident reports are presented. This is followed by a review 
of the interview results from Phase 2. 

A numerical summary of the pedestrian accident reports gathered for the project is 
shown in Table 1. The reports are classified by the source of the information and by the 
victim's handicap. The period of information collection for each source is also 
displayed. 



Table 1: Sources of Pedestrian Accident Reports 



Source of Report 


Number of Pedestrian Accident Victims 


Handicapped 


Unknown 
Condition 


Total 


Children 


Elderly 


Atlanta Police 

Department 

(1/73-12/73) 

Grady Memorial 

Hospital 

(12/74-4/75) 

Piedmont Hospital 
(12/74-4/75) 

Total 
V 


85 

69 

125 

279 


31 

3 
116 
150 


180 

81 

299 

560 


296 

153 

540 

989 

J 



Number of Reports. An inspection of Table 1 reveals several interesting facts about the 
total number of accident reports from the three sources: 

1. Almost 55% of the total number of accident reports were collected from 
Piedmont Hospital in an 18-week period. 

2. Only 15% of the total number of accident reports were collected from Grady 
Memorial Hospital during the same 18-week period. 

3. Only 30% of the total number of accident reports were collected from the 
Atlanta Police Department during an entire year. 



18 



There are at least two reasons for this apparent incongruity. The first reason concerns 
the type of information provided by each source. For example, the large number of 
accident reports from Piedmont Hospital is attributed to the incomplete information on 
the hospital record. In many cases, the hospital record from the emergency room 
provided only the general category of the accident, such as "fall." No details were 
given about how and where the accident occurred. The absence of this information 
complicated the selection of possible pedestrian accident reports. In order to obtain all 
of the valid pedestrian accident reports, a large number of questionable accident 
reports were included in the sample. 

By contrast, the hospital records at Grady Memorial were more descriptive about the 
cause of the accident. The Grady records frequently contained the exact cause of the 
accident, such as "hit by a car." This additional information enabled the Grady Hospital 
personnel to more accurately identify possible pedestrian accidents. 

All of the cases selected from the Atlanta Police Department file involved collisions 
between vehicles and pedestrians. Therefore all of the reports selected from this 
source were known to be pedestrian accidents and no judgment or evaluation was 
required. 

The second reason for the dissimilar distribution of reports among the three sources is 
the type of accident reported at each source. While the hospital records contain all 
types of pedestrian accidents, the only type of pedestrian accident reported in the 
police file is the collision between a pedestrian and a vehicle. Therefore, the police file 
contained fewer cases because it received only one type of pedestrian accident. 

Classification of Accident Victims . The numbers in Table 1 show an unequal 
distribution of handicapped types among the three sources. While a little more than 
half the victims from each source are neither children nor elderly, the relative 
distribution between these two identifiable handicap groups varies significantly. For 
example, 45% of the accident victims at Grady Hospital were children and only 2% of 
the accident victims were elderly, while at Piedmont Hospital 21% of the accident 
victims were elderly and only 23% of the accident victims were children. The statistics 
for the Atlanta Police Department reflect a situation between the two extremes, with 
29% of the accident victims being children, and the elderly representing 10% of the 
total number of accident victims. 

This unequal distribution of different types of handicapped accident victims can 
probably be explained by a consideration of the areas serviced by each source. The 
central city area, served by Grady Hospital, has a high concentration of families. 
Hence there are many children and many accidents involving children. The central city 
area also has fewer offstreet play areas and more multi-family dwelling units. These 
factors also contribute to the large number of pedestrian accidents involving children. 
The area of service for Piedmont Hospital is the near north side of Atlanta. This area 
has a relatively low concentration of families. There are many single people living in 
this area and a large number of senior citizens' housing projects are also located there. 
Therefore, Piedmont Hospital received more elderly people and fewer children. The 
Atlanta Police Department serves the central city area and the near north side area as 

19 



well as the rest of the City of Atlanta. Therefore, the accident statistics from that 
source show a distribution between the two extremes. 

Interviews . The interviewers attempted to conduct telephone interviews with 989 
possible pedestrian accident victims. The numerical results of the success rate of these 
interviews are provided in Table 2. 

Classification . As can be seen from Table 2, the results of the completed interviews 
were classified into seven categories. An eighth category was reserved for uncompleted 
interviews. A preliminary separation was made between the victims who were 
interviewed and those who were not interviewed. There were two classifications of 
victims who were not interviewed: (1) victims who could not be contacted, (2) victims 
who could be contacted but chose not to cooperate. Many of the uncooperative victims 
cited pending legal situations in their refusal. Another group of uncooperative victims 
maintained that they were never involved in an accident. Several situations contributed 
to the large number of victims who could not be contacted by telephone: the telephone 
had been disconnected, the telephone number had been changed to an unlisted number, 
or the person had moved. 

Five classifications were used for interviewed victims. The first classification was for 
victims of nonpedestrian accidents. A large portion of the nonpedestrian accidents 
were household falls. Nonhandicapped pedestrian accident victims were classified into 
the second group. The handicapped pedestrian accident victims who had been 
interviewed were classified into three categories: elderly, children, and other 
handicapped people. The elderly and children classifications were given precedence 
over the third category in cases involving multihandicapped victims. 

Analysis . An analysis of the numbers in Table 2 shows several interesting facts about 
each of the information sources. The statistics for the Atlanta Police Department 
reports reveal a large number of uncompleted accident reports. This fact may be 
attributed to an oversight in the distribution or collection of these reports. The 
numbers in Table 2 also show a very small number of nonpedestrian accident reports at 
the Atlanta Police Department. This could be expected due to the nature of the source. 
The distribution of handicapped pedestrian accident victims is very similar to the 
corresponding distribution in Table 1. 

The distribution of handicapped pedestrian accident victims from Grady Memorial 
Hospital is also very similar to the corresponding distribution in Table 1: predominantly 
children, with very few elderly people. There were also several other handicapped 
pedestrian accident victims from Grady. Many of the nonpedestrian accidents from 
Grady involved children on bicycles. 

Piedmont Hospital accident statistics show a large number of nonpedestrian accidents. 
Many of these accidents were household accidents or recreational accidents. The large 
number of people treated at Piedmont who declined to cooperate might be attributed to 
higher personal income and a desire for privacy. The distribution of handicapped people 
is almost evenly divided between the elderly and the children, just as in the 
corresponding distribution in Table 1. Piedmont Hospital also treated several other 
handicapped pedestrian accident victims. 

20 





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21 



Subgroups . The distribution of the 105 pedestrian accident victims that were 
interviewed is shown in Table 3. The distribution is heavily weighted toward the elderly 
and the school age children. Preschool children are also a significant accident group 



Table 3. Distribution of Handicapped Pedestrian Accident Victims 
That Wsre Interviewed 



r 




Subgroup 


Number of Victims 


>V 




1. 


Walking with special aids 


2 






2. 


Walking with difficulty without 
the use of special aids 


4 






3. 


Confined to wheelchair 









4. 


Chronic impairment of upper 
extremities and shoulders 


1 






5. 


Pre-school children (under age 6) 


11 






6. 


School age children (ages 6-17) 


51 






7. 


Elderly people (over age 65) 


28 






8. 


Severe auditory impairment 


1 






9. 


Severe visual impairment 


2 




{ 


10. 


Obvious confusion and/or disorientation 


5 


J 



B. Final Results 

The final results are those associated with the evaluation of the causes and 
counter measures of the 53 pedestrian accidents that were considered in Phase 3. The 
specific causes and counter measures associated with each accident are contained in the 
Pedestrian Accident Summaries in Appendix B. This section considers the more general 
categories of causes and counter measures identified in those 53 accidents. 

Identification and Incidence 

The evaluation of the specific causes and countermeasures of each Pedestrian Accident 
Summary (see Appendix B for summaries) has led to the identification of the general 
causes and countermeasures of pedestrian accidents of elderly and handicapped people, 
as shown in Table 4. 



22 



Table 4: Pedestrian Accidents: Causes and Counter measures 



General Causes 



General Counter measures 



5. 



6. 



7. 



The failure to accommo- 
date handicapped people in 
the design and operation of 
pedestrian facilities. 

The failure to consider 
pedestrians in the design of 
vehicular traffic facilities. 



The lack of an adequate 
separation or delineation 
between pedestrian areas 
and non-pedestrian areas. 

The failure to insure that 
each street is used for its 
intended purpose. 



The failure of the pedes- 
trian to consider con- 
flicting vehicular traffic 
prior to crossing the street. 

The failure of the pedes- 
trian to consider con- 
flicting vehicular traffic 
while crossing the street. 

The failure of the pedes- 
trian to use the available 
street crossing facilities. 



1. Design and operate pedes- 
trian facilities to accommo- 
date the handicapped. 



2a. Design vehicular traffic 
facilities for the safety of 
vehicular traffic and pedes- 
trian traffic. 

2b. Provide a safe school trip 
for young pedestrians. 

3. Provide an appropriate de- 
lineation or separation be- 
tween pedestrian areas and 
non-pedestrian areas. 

4. Use traffic engineering 
countermeasures to insure 
that each street is used for 
its intended purpose. 

5. Provide information (partic- 
ularly to children and the 
elderly) about safe and 
proper pedestrian behavior. 



6. 


Same as 
No. 5. 


Countermeasure 


7. 


Same as 
No. 5. 


Counter measure 



23 



Table 4: Pedestrian Accidents: Causes and Counter measures (continued) 



General Causes 



8. The failure of the elderly 
to realize and adapt to 
their decreased mobility. 

9. The driver's disobedience 
of vehicular traffic regula- 
tions. 

10. The failure of the parents 
or guardians to properly 
supervise and educate their 
children. 



11. The failure to keep the 
pedestrian environment 
clean and free of debris. 

12. The presence of factors 
which decrease visibility 
between the driver and the 
pedestrian. 



General Counter measures 



9. 



Same as Countermeasure 
No. 5. 



Prosecute dangerous drivers 
for the violation of traffic 
regulations. 



10a. Encourage parents to take 
more responsibility for the 
supervision and education of 
their children. 

10b. Provide information to 
school children and safety 
personnel about safe and 
proper pedestrian behavior. 

11. Keep the pedestrian envi- 
ronment clean and free from 
debris. 

12. Remove objects which 
obstruct visibility between 
drivers and pedestrians. 



24 



Description 

While the identification and incidence of the various causes and countermeasures is 
valuable, a more detailed description of each general cause and countermeasure is also 
required. Each description is based on the examples of specific accident reports from 
the research. 

General Causes 

The general causes and countermeasures are arranged under several headings which 
specify the broad area of classification. 

Design 

1. The failure to accommodate handicapped people in the design and operation of 
pedestrian facilities. 

The causes of pedestrian accidents included in this category reflect the 
misjudgments made by the designer. The designer simply fails to consider that 
handicapped people will use that facility. Examples include: a lip on a sidewalk 
curb (1 case), inadequate lighting on interior steps (1 case), the absence of 
handrails on irregular outdoor stairs (1 case), and rough spots in the sidewalk 
pavement (1 case). These inadequate facilities are the cause of many falling type 
accidents. 

2. The failure to consider pedestrians in the design of vehicular traffic facilities. 

Many vehicular traffic facilities are designed exclusively for the vehicle; 
pedestrians are not considered. This type of design is very appropriate for limited 
access highways such as the Interstate System. However, the same type of design 
is totally inappropriate for most city streets and other traffic facilities. This lack 
of consideration for the pedestrian causes many collisions between pedestrians and 
vehicles. 

Some accidents are caused by a lack of any consideration for the pedestrian. 
Examples include: vehicular parking lots with poor pedestrian access (1 case), busy 
streets without sidewalks (2 cases), and bus stops at busy intersections without 
crosswalks (1 case). 

Additional pedestrian accidents are caused by a lack of proper consideration for 
the pedestrian. While some provisions are made for the pedestrian, these 
provisions frequently do not satisfy the need. For instance: the provision of 
crosswalks on busy streets without traffic control devices (5 cases), the provision 
of pedestrian traffic signals without adequate crossing time (1 case), and the 
provision of a crosswalk at a busy intersection without a stop line on the vehicular 
approach (2 cases). 



25 



There is also a failure to consider pedestrians in the maintenance of traffic 
facilities. Disappearing crosswalk stripes (1 case), and nonfunctioning pedestrian 
actuation buttons (1 case) are examples of this neglect. 

Finally, the designer must provide more than an initial consideration to the 
pedestrian at vehicular traffic facilities. In some cases, the designer will have to 
reevaluate the original provisions and make necessary modifications. 

3. The lack of an adequate separation or delineation between pedestrian areas and 
nonpedestrian areas. 

The unchecked accessibility from pedestrian areas to nonpedestrian areas is 
another major cause of pedestrian accidents. This freedom to wander into areas 
which are neither designed nor intended for the pedestrian is very dangerous. 
People who are unaware of this danger, such as children and the elderly, are 
frequently involved in this type of accident. Many accidents involve a collision 
between the pedestrian and a vehicle. This causal factor was identified in the 
following situations: the lack of any delineation between a busy street and an 
adjacent parking lot (1 case), the lack of any separation between the sidewalk and 
the street below the crest of a vertical curve (1 case), the absence of any 
separation between a sidewalk and a busy street with no curb parking (1 case), and 
the lack of any separation between pedestrian areas and a railroad right of way. 

4. The failure to insure that each street is used for its intended purpose. 

Pedestrians expect that all streets will be used for their intended function. 
People expect that: expressways will be used for high speed through traffic, 
arterials will be used for medium speed through traffic and local streets will be 
used for low speed local traffic. The pedestrian adapts his behavior to these 
expectations. When these expectations are violated, the pedestrian is in a 
dangerous situation which can cause pedestrian accidents. 

Children appear to be involved in most of these accidents. Their lack of 
experience in traffic leads them to believe that the street in front of their house 
is a safe local residential street. This causal mechanism was observed in two of 
the accidents in this study (2 cases). 

Pedestrian Behavior 

5. The failure of the pedestrian to consider conflicting traffic prior to crossing the 
street. 

This type of accident is clearly the fault of the pedestrian. Because of 
carelessness or immaturity the pedestrian enters the street with no regard for 
vehicular traffic. Accidents occur when the driver of the vehicle is unable to 
avoid the collision. 

Many of these accidents involve children running into the street (5 cases). 

26 



Another involved a child running into the path of a vehicle in a parking lot. 
Additional accidents of this type include: a child running from behind a visual 
obstruction, such as a slow moving bus or a telephone pole. In one example, the 
pedestrian saw the vehicle but he misjudged the vehicle's distance and/or speed. 

6. The failure of the pedestrian to consider conflicting vehicular traffic while 
crossing the street. 

This cause is very similar to the previous one. In this case, the pedestrian makes a 
careful consideration of conflicting traffic before he starts to cross, but he fails 
to look for traffic while he is crossing. These accidents usually occur on busy 
streets with moderately high speed traffic. Slow moving elderly people are 
involved in many of these accidents. 

Some of these accidents occur away from a crosswalk (2 cases); others occur 
inside a crosswalk (3 cases). Pedestrians crossing in a crosswalk mistakenly 
assume that the driver will stop and yield the right of way. This unproven trust in 
the driver's obedience to traffic regulations is the cause of many accidents. 

Other pedestrian behavior patterns in this category include : the failure to consider 
the second or third lane of traffic on a multilane street and the inability of the" 
pedestrian to move out of the street when a vehicle is sighted. 

7. The failure of the pedestrian to use the available street crossing facilities. 

This cause of pedestrian accidents involves elderly people and children. Following 
a path of least resistance, the pedestrian decided to cross the street away from a 
crosswalk. The driver of the vehicle does not expect this action and a collision 
occurs (8 cases). The decision to cross the street away from a crosswalk may be 
influenced by the ineffectiveness of some crosswalks (see General Cause No. 1, 
Table 4). 

8. The failure of the elderly to realize and adapt to their decreased mobility. 

This deficiency on the part of elderly people is a significant cause of many minor 
pedestrian accidents and a few major pedestrian accidents. Several specific 
examples of this general causal factor were identified in the research. The first 
example concerns the failure of the elderly pedestrian to realize that he walks 
more slowly and that it takes him longer to move across a street (2 cases). 
Another example is the failure of the elderly to avoid hazardous locations, such 
as: busy streets (1 case), slippery pavements (1 case), irregular pavements (2 
cases), and drainage gratings (1 case). The elderly pedestrian also fails to exercise 
normal caution and walks down steps backwards (1 case). 

Driver Behavior 

9. The driver disobeying vehicular traffic regulations. 

Not all pedestrian accidents are caused by inadequate design or by pedestrian 

27 



behavior. The behavior of the driver is also a significant causal factor in many 
accidents. The most dangerous and flagrant type of driver behavior is disobeying 
vehicular traffic regulations. These violations include: failure to yield right of 
way to a pedestrian in a crosswalk (2 cases), stopping a vehicle in a crosswalk (1 
case), speeding (2 cases), and failure to obey a "STOP" sign (1 case). 

Supervision and Education 

10. The failure of parents or guardians to properly supervise and educate their 
children. 

This causal mechanism is the most prevalent and probably the most serious cause 
of children's pedestrian accidents. Many accidents of pre-school children are a 
direct result of the parents' lack of concern (2 cases). However, supervision is not 
restricted to young children. It extends to older children in special cases, such as 
reminding the child to wear eyeglasses (1 case). 

Pedestrian accidents of older children are frequently caused by the child's 
ignorance of safe pedestrian practices. Many children do not know how to cross a 
busy street (7 cases), or why to cross in front of a school bus (1 case) or how to 
cross from behind a visual obstruction (1 case). Although the schools may provide 
some assistance the primary responsibility for this education rests with the 
parents. 

Maintenance 

11. The failure to keep the pedestrian environment clean and free from debris. 

A cluttered and dirty pedestrian environment is very hazardous to elderly and 
handicapped pedestrians. Slippery conditions, such as water on a greasy and oily 
pavement (1 case) are very hazardous to elderly people. The presence of grass and 
weeds on irregular stone steps (1 case) is very dangerous for everyone. 

12. The presence of factors which decrease visibility between the driver and the 
pedestrian. 

Trees, bushes and even street furniture such as telephone booths and lighting poles 
screen pedestrians who are preparing to cross the road at a crosswalk from 
driver's view. 

General Countermeasures 

Design 

1. Design and operate pedestrian facilities to accommodate the handicapped. 

In order to reduce the number of pedestrian accidents, design pedestrian facilities 
for safe use by handicapped people. Specifically, the designer should: provide 

28 



hand railings for outdoor stairs (1 case), provide proper illumination of indoor 
stairs (1 case), and eliminate irregular pavement surfaces (2 cases). 

2a. Design vehicular traffic facilities for the safety of vehicular traffic and 
pedestrian traffic. 

Consider pedestrian traffic as a significant factor in the design of a vehicular 
traffic facility. In many instances, pedestrians must interact with vehicles at 
these locations. Due to the pedestrian's disadvantages in size, weight, and energy, 
the pedestrian must be protected from the vehicle at all times. 

f Specific counter measures in this general category are: locate crosswalks and bus 
stops on busy streets only where traffic control devices are present (6 cases), 
provide a stop line on the multilane approaches to busy pedestrian intersections (2 
cases), and provide a clear and continuous pedestrian path across the intersection 
(2 cases). 

Additional specific countermeasures include: examine the possibility of a traffic 
control device for locations with significant pedestrian movement across a busy 
street (1 case), provide adequate pedestrian crossing time at a signalized 
intersection (1 case), and provide a safe path for the pedestrian through a 
vehicular parking lot (1 case). 

Finally, evaluate the initial countermeasures to make sure that they provide 
adequate protection for the pedestrian (1 case). 

2b. Provide a safe school trip for young pedestrians. 

Due to the number of trips made by these inexperienced pedestrians, the 
implementation of this countermeasure is very important. Specific counter- 
measures in this general category are: provide a safe route to school (1 case), 
eliminate or discourage unsafe routes (1 case), and insist that children who ride a 
bus to school follow proper safety procedures at the bus stop (1 case). 

3. Provide an appropriate delineation or separation between pedestrian areas and 
nonpedestrian areas. Prevent interaction between the pedestrian and the vehicle 
if the interaction is unwarranted and dangerous. 

Specific countermeasures proposed for accident sites in this project are: 
delineate the vehicular street from the adjacent parking lot by the use of a curb, 
sidewalk, or pavement marking (1 case); erect a fence to keep pedestrians outside 
the railroad right of way (1 case); separate the sidewalk from the street at 
dangerous locations, such as a small business district with no curb parking (1 case) 
or below the crest of a vertical curve (1 case). 

4. Use traffic engineering countermeasures to insure that each street is used for its 
intended purpose. 

Vehicular traffic must be discouraged from speeding through residential streets 

29 



where children frequently run into the street. One method available for 
implementation is the physical modification of the existing street network (2 
cases). 

Pedestrian Behavior 

5. Provide information (particularly to children and the elderly) about safe and 
proper pedestrian behavior. 

Children are not the only people who require education about pedestrian safety, 
all pedestrians are at risk. Elderly people particularly need to be retrained to 
cope with today's pedestrian environment. Faster vehicles, additional traffic, and 
new regulations, as well as the physical condition of the elderly person, create the 
need for a refresher course in proper pedestrian behavior. 

An educational program for senior citizens should include the following lessons: 
how and why to look for vehicles while crossing a street (2 cases); how and why to 
avoid busy streets (1 case), slippery pavements (1 case), drainage gratings (1 case), 
and uneven pavements (2 cases); and how and why to avoid foolish actions, such as 
stepping down stairs backward (1 case). 

6. Same as Countermeasure No. 5. 

7. Same as Countermeasure No. 5. 

8. Same as Countermeasure No. 5. 
Enforcement 

9. Prosecute dangerous drivers for the violation of traffic regulations. 

The modification of pedestrian behavior cannot eliminate all pedestrian accidents. 
Some pedestrian accidents are strictly the fault of the driver; the pedestrian is 
not at fault and he is unable to take any evasive action. Some of these accidents 
can be eliminated by a modification of driver behavior. One way to modify the 
driver's behavior is by consistent prosecution of unsafe drivers. 

Some of the dangerous violations which require more consistent enforcement and 
prosecution are: failure to yield to a pedestrian in a crosswalk (2 cases), stopping a 
vehicle in a crosswalk and backing a vehicle over a crosswalk (1 case), speeding (2 
cases), and failure to obey a "STOP" sign (1 case). 

Supervision and Education 

10a. Encourage parents to take more responsibility for the supervision and education of 
their children. 

Parents have very good opportunities and reasons for instructing their children 

30 



about proper pedestrian behavior. During the daily contact between parent and 
child, the parent has ample opportunity to teach and to demonstrate pedestrian 
safety. In addition to opportunity, the parent also has a responsibility to protect 
the child from dangerous situations. This responsibility includes an education in 
pedestrian safety. 

Parents should teach their children: how to cross a busy street (6 cases); how to 
cross a street from behind a visual obstruction (1 case); why to cross in front of a 
stopped school bus (1 case); and why to wear corrective eyeglasses (1 case). While 
parents are teaching younger children (preschool age), supervision must be 
maintained (2 cases). 

10b. Provide information to school children and safety personnel about safe and proper 
pedestrian behavior. 

When the child goes to school a large portion of the general educational 
opportunity and responsibility goes with him. The schools should reiterate and 
continue the instruction started by the parents (7 cases). (See General Cause No. 
6, Table No. 4). The school should emphasize safety during the school trip (3 
cases). 

Maintenance 

11. Keep the pedestrian environment clean and free from debris. 

In order to move people effectively and safely, pedestrian facilities must provide 
a clear path of travel. If the facilities are not properly maintained, the original 
design becomes hazardous and counter measures are ineffective. Falling type 
accidents are the major result of a poorly maintained pedestrian facility. 

This research shows two examples of improper maintenance: (1) grass and weeds 
growing over and through a pedestrian pavement (1 case), and (2) rainwater 
reacting with an unkempt greasy, oily pavement to produce a slippery and 
hazardous pedestrian surface (1 case). 

12. Remove objects which obstruct visibility between driver and pedestrian. 

To prevent places where pedestrians cross from being screened from driver's view 
by bushes, trees, etc., an effective maintenance program should clear these areas 
routinely; and arrangements should be made to have street furniture relocated to 
positions that do not interfere with sight lines. 

Conclusions 

The results of this research have provided the basis for the following conclusions. The 
conclusions are separated into two categories: those based on the research procedure 
and those based on the case studies. 



31 



Research Procedure 



Sources 



1. Hospital records are the best available source of information concerning 
nonvehicular pedestrian accidents. The availability of the hospital record on the 
day following the accident is a significant asset in contacting victims. Weak- 
nesses in the process of using these records for the generation of pedestrian 
accident reports include: the inefficiency of collecting a large number of 
nonpedestrian accident reports, the absence of a definite accident location, and 
the absence of accident details. All of these weaknesses are results of the lack of 
appropriate information on the hospital record. 

2. Police reports are the best source of information concerning accidents involving 
pedestrians and vehicles. Each report defines the exact location and the exact 
details of the accident. However, the use of the police reports also has three 
weak points. They are: the absence of the victim's telephone number, the long 
delay imposed between the time of the accident and the time of the possible 
interview, and the difficulty associated with the location of the pedestrian 
accident reports in the vehicular accident file. 

Interviews 

3. The telephone interview technique is a valuable tool for establishing the victim's 
verbal description of the accident. 

4. The telephone interview technique is not particularly useful for the field study of 
an accident site. The victim's description of the accident site is frequently 
unclear or inaccurate. It is frequently improbable and occasionally impossible. 
The lack of visual contact between the interviewer and the victim undoubtedly 
contributes to this information gap. 

Involvement 

Elderly and handicapped people are involved in a significant portion of all 
pedestrian accidents. Subgroups of the handicapped population which show a high 
degree of involvement are: school age children, elderly people, and pre-school 
children. The absence of other subgroups from the pedestrian accident reports is 
particularly attributable to the inaccessibility of many pedestrian facilities. 

Case Studies 

The conclusions concerning the final results of this research are separated into 
two categories: causes and countermeasures. The major causes and counter- 
measures for the pedestrian accidents of the two significant and identifiable 
groups, the elderly and children, are also presented. 



32 



Causes 

5. Many pedestrian accidents of handicapped people are caused by several 
contributing factors. Some of these general causes occur at the time of the 
accident; others occur over several years prior to the accident. Some of the 
causes are the fault of the pedestrian; others are not the fault of the pedestrian. 
Most of these causes can be reduced or eliminated by one or more counter- 
measures. 

6. While the causes of pedestrian accidents of handicapped people are similar to the 
causes of pedestrian accidents of the general population, the handicapped are 
more susceptible to each of the causal mechanisms and more likely to be involved 
in each of the accident types. 

7. The Elderly. The primary causes of pedestrian accidents of the elderly are the 
inadequate design of pedestrian facilities and the failure of the elderly to realize 
and adjust to their handicaps. Associated secondary causes include the failure to 
consider conflicting vehicular traffic while crossing the street and the failure to 
use the available pedestrian facilities. 

8. Children. The failure of parents to provide proper supervision and education for 
their children is the primary cause of children's pedestrian accidents. The failure 
of the school to provide similar services is also a significant causal factor. 

The child's lack of pedestrian safety education manifests itself in several 
dangerous pedestrian actions which cause accidents. They include: the failure to 
consider conflicting vehicular traffic prior to crossing the street, the failure to 
consider conflicting vehicular traffic while crossing the street, and the failure to 
use the available pedestrian facilities. 

9. Other groups of handicapped people. Any conclusions about the causal factors of 
any other group of handicapped people would be presumptuous due to the limited 
number of accident reports. 

10. All handicapped people. A major causal factor of the pedestrian accidents of all 
handicapped (and all nonhandicapped) people is the ineffectiveness and/or 
unreliability of present pedestrian facilities. 

Counter m easures 

11. The solutions to many pedestrian accident problems are composed of several 
countermeasures. Each of these countermeasures must be coordinated with the 
others to provide an effective solution. 

12. The design of pedestrian facilities and the implementation of physical design 
countermeasures must consider the characteristics of the handicapped person. 



33 



13. Elderly. The two primary counter measures for the reduction of pedestrian 
accidents of elderly people are: (1) the modification of the design of pedestrian 
facilities to accommodate elderly people, and (2) the education of elderly people 
concerning safe pedestrian behavior. 

The characteristics of elderly people should be considered from a physical 
perspective and a psychological perspective. Important physical characteristics 
include failing eyesight, and a slow, shuffling walk. The elderly person's inability 
to make quick or complicated decisions are important psychological factors. 
Educational programsshould teach the elderly person how to adjust to his 
handicap. Critical pedestrian behavior patterns, such as how and where to cross a 
street, should be emphasized. 

14. Children. A reduction in the number of pedestrian accidents involving children 
can be most effectively accomplished with an educational process. The parents 
and the schools must cooperate in this instruction of proper pedestrian behavior. 
The individual lessons should include: how to look for conflicting vehicles prior to 
crossing the street, how to look for conflicting vehicles while crossing the street, 
and how to use the available pedestrian facilities. 

15. All handicapped people. All physical design countermeasures for the reduction of 
pedestrian accidents of handicapped people (and nonhandicapped people) must be 
effective and reliable. If the countermeasures do not meet these criteria, they 
are of little practical value. 

the five city accident survey 

Police and hospital emergency room records provide a useful indication of pedestrian 
accidents, but neither source is wholly satisfactory. In the first place, police 
intervention occurs in a small fraction of pedestrian accidents, and the overwhelming 
majority of pedestrian accidents that are reported to the police involve motor vehicles; 
few other types of pedestrian accidents are reported to the police. Hospital emergency 
rooms, on the other hand, treat people injured in all types of accidents, but many 
accidents are not severe enough to require the victim to have emergency room 
treatment, and many accident victims are treated at doctors' offices and at other 
healthcare locations. And finally, accidents in which the handicapped are involved are a 
relatively small proportion of the total, so many records must be scanned in order to 
turn up these few accidents. 

The Atlanta accident studies described earlier suffer from these limitations. Most of 
the accidents involved vehicles— few non-vehicular accidents were reported. Further- 
more, most of the accidents involved the elderly and children; few accidents involving 
other groups of handicapped people turned up in the sample investigated. 

For these reasons, it was necessary to try to obtain additional information on non- 
vehicular accidents, particularly those in which handicapped people are involved. As 

34 



discussed earlier, there is little in the literature that is useful, so it was decided to 
gather additional information as part of a survey conducted in five U.S. cities. 

The primary function of the Five-City Survey was to identify the environmental 
problems, rather than hazards, experienced by elderly and handicapped pedestrians. 
Nevertheless, the nature of the survey made it possible to include questions on 
accidents. The survey was conducted in five cities chosen for their climatic, 
topographic, regional, social and economic differences (San Francisco, Seattle, Chicago, 
Tampa/St. Petersburg, Atlanta). A fuller description of the (problems) survey, including 
the techniques used and the findings, are included in Part 2 of this volume, 
"Environmental barriers and problems." 

For the surveys, a focused interview technique was used. The interviewer did not 
attempt to control the conversation except to introduce, from time to time, new topics 
drawn from a pre-determinied check list. As part of this check list, the subjects were 
asked if they had been involved in any pedestrian accidents. If the answer was 
affirmative, then the interviewer used a special form (see Appendix A, this is the same 
form used for the Atlanta accident survey), and probed the nature and cause of the 
accident as described by the victim. The victim's responses were entered on the form, 
and with permission, the interviews were also tape recorded; these recordings were used 
later to elucidate and elaborate on the written notes. 

The subjects that were interviewed were elderly and handicapped people who were 
identified for the project team by more than eighty local social and health service 
agencies, community associations and organizations representing elderly and other 
disability groups. 

Results 

A total of 338 people were interviewed— 92 in Tampa/St. Petersburg, 73 in Chicago, 67 
in San Francisco, 65 in Seattle and 41 in Atlanta (see Appendix C). And 174 of these 
people reported involvement in pedestrian accidents that fall within the scope of this 
study— pedestrian accidents that occurred in or out-of-doors, but not in domestic 
kitchens, bathrooms, bedrooms, living rooms, offices, etc.; in other words, accidents 
that occurred within the pedestrian movement system. 

The high percentage of subjects that reported accidents can probably be explained by 
the ground rules of the survey. The subjects were encouraged to discuss any pedestrian 
accidents that they had experienced within the period in which they had their present 
handicap. And secondly, they were encouraged to discuss even those accidents where no 
serious injury had eventuated. The purpose of the survey was to find out the types and 
causes of accidents experienced by the various groups, so the date of the accident and 
the severity of the injury was unimportant. 

Table 5 shows the percentage of subjects in each disability group that reported an 
accident. From these data it can be seen that four of the groups reported 70% of the 
174 accidents, and the highest percentage of reported accidents, and in these terms can 
be considered to be the higher risk groups, 

35 



• Develop mentally restricted (77% reported accidents). 

• Wheelchair users (63% reported accidents). 

• Those with lower extremity impairments who walk using special aids (75% 
reported accidents). 

• Severely visually impaired (62% reported accidents). 

Table 6 presents a cumulative summary of the accident data from the five cities. Data 
from each of the five cities individually can be found in Appendix C. 



Table 5: Accident Reportage by Various Handicap Groups 



/" 




Subjects 
Interviewed 


Accidents 
Reported 


Percentage 

Reporting 

Accidents 


N 




Developmental 
Restrictions 


13 


10 


77 






Chronic Restrictions 
(agility/stamina/ 
reaction time) 


40 


21 


53 






Wheelchair Users 


62 


39 


63 






Walks w/ Special 
Aids 


57 


43 


75 






Walks w/Difficulty 


36 


8 


22 






Upper Extremities 


8 


3 


38 






Severe Auditory 
Impairment 


38 


8 


21 






Severe Visual 


52 


32 


62 






Impairment 












Confused/ 
Disoriented 


32 


10 


31 




Totals 


338 


174 


51 


J 



36 



cu 
a 
a 

O 






TD 




C 




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>> 




r— 1 




S-. 




QJ 




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alks, corridors 

rosswalks 

urbs, curbcuts 

amps 

;airs 

andrails 

ratings, manho] 

gnals 

ick-up, waiting 

oors, lobbies 

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37 



Table 7 is based on Table 6 and indicates, for each handicapped group, the types of 
accidents that they reported. Thus we find that 40% of all the accidents reported by 
people with developmental disabilities were falls on the level; 30% were falls while 
changing level (steps, ramps, etc.); and 30% were accidents involving motor vehicles. 
From Table 7 it can be seen that nearly half (47%) of all the accidents reported 
occurred while the victim was traveling on level surfaces. Another 32% occurred while 
the victim was ascending or descending from one level to another. And 20% were 
accidents in which vehicles were involved. 



Table 7: 


Percentage 


of Accidents by Type of Handicap 




Falls 
on Level 


Falls 

Changing 

Level 


Hit 

by Vehicle 


Pedestrian A 

and 

Pedestrian* 


Developmental 
Restrictions 


40 


30 


30 





Chronic Restrictions 
(agility /stamina/ 
reaction time) 


48 


38 


14 





Wheelchair Users 


64 


28 


5 


3 


Walks w/ Special 
Aids 


51 


35 


12 


2 


Walks w/Difficulty 


38 


13 


50 





Upper Extremities 





33 


67 





Severe Auditory 
Impairment 


50 


25 


25 





Severe Visual 
Impairment 


28 


44 


25 


3 


Confused/ 
Disoriented 


40 


10 


50 





Totals (all Subjects) 
V 


47 


32 


20 


2 J 



'Accident resulted from contact with another pedestrian 



38 



The accident patterns of some handicapped groups differ markedly from that of the 
whole group. The reports from: 

• the developmental^ disabled show that 40% of the accidents involved vehicles. 
This is not altogether unexpected, as this group consists mostly of children, and 
children tend to be over represented in pedestrian/vehicular accident reports; 

• the wheelchair users show that 64% of their accidents occurred on level walkways; 

• people who walk with difficulty but without the use of special aids show that 50% 
of their accidents involved vehicles; 

• those with severe visual impairments show that 44% of their accidents were falls 
at walkway level changes; and 

• the confused/disoriented group show that 50% of their accidents involved motor 
vehicles. 

In Table 6 the environmental components and elements where the accidents occurred 
are listed. For the purposes of this study, an element is an individual piece of the 
pedestrian system; i.e., a curb ramp, a stair, a bench, a crosswalk, etc. A component is 
a grouping of elements which forms one part of a system; i.e., a street crossing is a 
component, and it may consist of the following elements: curb ramps, signals, signs, 
crosswalk, etc. 

From Table 6 it can be seen that 160 (92%) of all the accidents occurred on four of the 
components— walkways 21 (39%), street intersections 51 (29%), public spaces/parks 17 
(10%), building entrances/lobbies 24 (14%). 

And from Table 6 it can be seen that 142 (82%) of all accidents occurred on only four of 
the elements: 

• 63 (36%) of all the accidents were falls on walks and corridors— slips on ice and 
snow or on slick surfaces, trips on badly maintained surfaces, falls caused by 
unexpected potholes, etc.; 

• 29 (17%) of the accidents occurred while crossing the street— approximately the 
same percentage that were involved in accidents with motor vehicles; 

• 20 (11%) of the accidents occurred at curbs or curb cuts; 

% 30 (17%) of the accidents occurred on stairs. This is not ur^xpected. From the 
evidence of the U.S. Consumer Product Safety Commission, stairs are the most 
dangerous consumer product. 

A further examination indicates that the accidents experienced by some handicapped 
groups occurred predominantly on particular environmental elements. 



39 



• Developmental disabled— 4 (40%) of the accidents occurred on walkways and 
corridors. 

• Wheelchairs— 19 (56%) of the accidents occurred on walkways and corridors; 7 
(18%) on curbs and curb ramps. 

• People who walk with aids— 17 (40%) of the accidents occurred on walkways and 
corridors; 8 (20%) on stairs, and 7 (14%) at curbs and curb cuts. 

• Visually impaired— 10 (31%) of the accidents occurring at stairs, 7 (22%) on 
walkways and corridors, 6 (19%) at curbs and curb cuts. 

These are the same four handicapped groups that were identified earlier as being the 
higher risk groups. 

Conclusions 

From the survey it can be concluded that four of the handicapped groups can be 
classified as experiencing higher risks in terms of accident probability. 

• Developmental^ restricted (mostly children) 

• Wheelchair users 

• Those with lower extremity impairments who walk using special aids 

• Severely visually impaired 

Three types of accidents predominated: 

Falls on the level (47% of all accidents). 64% of all wheelchair accidents occurred 
on the level. 

Falls at level changes (32% of all accidents). 44% of all accidents involving the 
visually impaired occurred at level changes. 

Accidents involving motor vehicles (20% of all accidents). 40% of accidents to 
the developmentally disabled, and 50% of accidents to those who walk with 
difficulty but without the use of special aids, and to those who are confused and 
disoriented, involved motor vehicles. 

Four pedestrian environment components were the loci for 92% of all the accidents: 

• walkways (39%) 

• street intersections (29%) 

40 



• public spaces, parks (10%) 

% building entrances, lobbies (14%) 

And four pedestrian environment elements were the loci for 82% of all the accidents 
reported. 

• Walks and corridors (36%) 

• 40% of all reported accidents to the develop mentally disabled 

• 56% of all reported accidents to people who use walking aids 

• 40% of all reported accidents to people who use walking aids 

• 22% of all reported accidents to visually impaired people 

• Street crosswalks (17%) 

• Curbs, curb ramps (11%) 

t 18% of all reported accidents by wheelchair users 

• 14% of all reported accidents by people who use walking aids 

• 19% of all reported accidents by visually impaired people 

• Stairs (17%) 

• 20% of all reported accidents by people who use walking aids 

• 31% of all reported accidents by visually impaired people. 

summary of accident studies 

The causes of the accidents in which elderly and handicapped pedestrians were injured 
can be grouped into five categories. 

Transportation planning failures 

Environmental design failures 

Environmental maintenance failures 

Pedestrian behavioral errors 

Driver behavioral errors. 

41 



Transportation planning failures are of three types: 

1. The failure to develop traffic plans for pedestrians, and particularly for elderly 
and handicapped pedestrians. This comment reflects the fact that usually traffic 
plans for cities are primarily for vehicles. The large percentage of pedestrian 
accidents could be reduced by implementing planned pedestrian networks in cities. 

2. -The failure to consider the pedestrian (particularly the elderly and handicapped) 

adequately in the design of vehicular traffic facilities. Examples include streets 
without sidewalks; bus stops at busy intersections without crosswalks; crosswalks 
in busy streets without traffic control devices; insufficient time permitted for 
crossing at traffic signals, etc. 

3. The failure to ensure that streets are used for their intended purpose. Pedestrians 
expect expressways to be used for high speed traffic; arterials for medium speed 
through traffic, and local streets for low speed local traffic. ' When these 
expectations are violated, the pedestrian becomes more vulnerable. 

Environmental design failures include failures of the components of the pedestrian 
movement system, and the elements from which they are composed. There are four 
environmental components that were the loci for most of the accidents: 

1. Walkways 

2. Street intersections 

3. Public spaces/parks/recreation areas 

4. Building entrances/lobbies 

and four elements within these components that were the loci for most of the accidents. 

1. Walks and corridors . The lack of adequate separation or delineation between 
pedestrian and vehicular areas. Children, the elderly, and the visually handi- 
capped wander off the pedestrian space into the vehicular way and are struck. 
Examples include the lack of delineation between a busy street and a sidewalk and 
between pedestrian and vehicular routes in parking lots. 

Other walkway hazards include unprotected building and repair sites, surfaces that 
are slippery or have tripping hazards. 

2. Street crosswalks . Design failures include the failure to provide stop lines and 
wide enough crosswalks; the location of trees and planting, poles, parked cars and 
other impediments that prevent drivers from having a good view of pedestrians 
preparing to cross; the presence of gratings, manhole covers, etc., in the 
crosswalk that may cause a slip or trip. 

3. Curbs, curb ramps . The failure to provide curb ramps; the provision of poorly 
designed and incorrectly located curb ramps; the use of very high and very low 

42 



curbs, and curbs that present tripping hazards; the location of drainage outlets and 
slippery gutters, etc., all contribute to the design problems of these elements. 

4. Stairs . The failure to design and locate stairs such that the inherent hazards can 
be reduced to a minimum. Implicit in the problem is the location of steps, stairs, 
ramps, and other abrupt level changes where people with poor sight may fail to 
detect them. Stair design failures may include incorrect riser/ tread proportions, 
handrails that are too high, too low, or not provided at all; inadequate or poorly 
conceived illumination, etc. 

Environmental maintenance failures include the failure to keep the pedestrian 
environment clear and free from debris and free from slippery conditions caused by 
water, or a greasy and oily pavement; grass and weeds growing on the surface, cracked 
and irregular sidewalk paving, potholes, puddles, snow and ice, etc. 

Pedestrian behavioral errors typically include: 

1. The failure to consider traffic prior to entry into a street: children run into the 
street or into the path of a vehicle in a parking lot. The problem may be 
compounded by a visual obstruction such as a telephone pole or a moving bus. 

2. The failure to consider conflicting vehicular traffic while crossing the street: the 
pedestrian observes the traffic before starting to cross, but fails to look for 
traffic while crossing. Slow-moving elderly people were involved in the accidents 
we studied. Examples include pedestrians mistakenly assuming that drivers will 
yield the right of way in crosswalks; pedestrians' failure to consider the second or 
third lane of traffic in a multilane street; and the inability of the pedestrian to 
move quickly out of the street when a vehicle is sighted. 

3. The failure of the pedestrian to use the available street-crossing facilities: the 
victim follows a path of convenience and crosses away from a crosswalk. Both 
elderly people and children are involved in accidents of this type. 

4. The failure of the elderly to realize and adapt to their decreased mobility: 
examples include their failure to realize that they walk more slowly than they 
used to and that they take longer to cross the street and their failure to avoid 
busy streets, slippery pavements, irregular pavements, drainage gratings, and so 
forth, all of which make walking hazardous. 

Driver behavioral errors include a failure to yield the right of way to a pedestrian in a 
crosswalk, stopping a vehicle in a crosswalk, speeding, failure to observe a stop sign, 
and so forth. 

In Part 1, the nature and causes of accidents experienced by the elderly and 
handicapped pedestrian have been presented. Part 2 will discuss the problems and 
barriers this group experienced in trying to overcome impediments in the pedestrian 
environment. 



43 



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introduction 



The pedestrian environment has evolved without sufficient attention given to the needs 
of people who are not young, able bodied adults. It would seem that the sidewalks, 
paths, walkways, crosswalks, and parks were conceived by planners for the needs of 
some 'average' person— someone who is of 'normal' adult proportions, and who has 
'normal' adult proportions, and who has 'normal' perceptiual, mental, and physical 
equipment and abilities. Obviously, this describes quite a small cross section of 
humankind. It excludes, by definition, children, those whose abilities are not 'normal'; 
and the elderly, whose abilities have deteriorated over time. 

This very limited conception of the 'average' pedestrian is obviously not a conscious 
attempt to discriminate. Nor is it simply a callous disregard for others. It is largely 
the result of being unaware. The urban policy makers and designers have, until 
recently, been unaware that their decisions cause problems. They have been unaware of 
the nature of the special needs of people other than 'normal' people. 

These design failures are easier to understand when we examine the planning reference 
sources that are available to professionals, for these sources provide little assistance. 
In fact, there are no sources that treat the subject adequately. And this is not 
surprising because, before design recommendations can be set out, it is necessary to 
seek out the problems and then develop solutions that will work for this much larger 
population. 

An exacerbating factor is that the pedestrian environment is seldom planned. It usually 
occurs as an adjunct to some other planned activity—sidewalks and adjoining roads, 
walkways through plazas and parks etc. The sidewalks and crosswalks are considered as 
necessary provisions for a successful vehicular traffic plan. But pedestrian traffic 
planning is almost non existent. 



For these reasons, the elderly and handicapped must try to negotiate a pedestrian 
environment that does not match their abilities. For some of them, parts of the 
environment are impossible; and for some, the environment is replete with unnecessary 
obstacles. 

The elderly and handicapped are not a homogenous group. They differ in their abilities 
and disabilities. In this part of the report, the target group are examined - the types of 
disability that handicap them, the numbers of people affected, and the nature of the 
problems and barriers that confront them in the pedestrian environment. 

44 



"Risk Population Among Pedestrians," discussed later in this part is directed at 
estimating the numbers of elderly and handicapped people that are likely to be affected 
by the pedestrian environment. "Environmental Problems for Elderly and Handicapped 
Pedestrians," reports on the results of a survey to find the problems and barriers that 
most frequently cause difficulties or prevent the target group from using parts of the 
towns in which they live. 

As a first step to understanding the problems, it is necessary to identify the types of 
human condition that separate the elderly and handicapped from the designers 'normal' 
person. As discussed earlier, we fail to provide for a wide enough cross section of 
human kind because we tend to design for a hypothetical person who has no apparent 
mobility limitations to using the pedestrian environment. The question that must now 
be addressed is what do we mean by 'handicapped' in the pedestrian sense. We usually 
think immediately of people who are visually impaired, and people who are in 
wheelchairs. But there are many other handicapping conditions, many of which are an 
inevitable part of the process of human existence. Children and the elderly, for 
example, have unusual difficulty in using the present pedestrian environment, and this is 
demonstrated by the fact that they tend to be disproportionately over represented in 
accident statistics. 

Classification and Definitions 

The terminology and criteria used in the literature to identify the elderly and the 
handicapped tends to be inconsistent and impermanent, and often reflects the objectives 
of whoever is promoting the definitions. Those groups or agencies that are primarily 
concerned with compensation or benefits for the handicapped tend to rely on medical 
diagnoses and definitions. For our purposes, this is not satisfactory for several reasons. 
First, any given medical condition may result in a variety of functional disabilities, each 
of which may or may not handicap the patient as a pedestrian. Second, the medical 
condition may have various degrees of severity, some of which may handicap the 
patient. 

A different direction is taken by those primarily concerned with rehabilitation. As their 
objectives are aimed at restoring or retraining the patient for vocational, educational, 
or at least home-related activities, the degree of handicap is often based on their 
ability to perform in these settings. Once again, these criteria are inadequate for this 
study. 



45 



A somewhat similar approach was chosen by ABT Associates (1968) for their 
investigation of travel barriers. They listed the activities that people would need to be 
capable of in order to be able to use various transit modes. These people should be able 
to: "walk more than one block," "move in crowds," "stand or wait," and "climb steep or 
long stairs," etc. For our purposes, to attempt to set out a compendium of functional 
requirements in this fashion would be to make assumptions on factors that are central 
to the research. It is our responsibility to seek out and identify these "functional 
imperatives" in terms of the problems and hazards they present to the target 
population. 

For these reasons, we have chosen to avoid using the causes (congenital, traumatic or 
medical) as criteria, and we have avoided attempting to define functional requirements 
for pedestrian travel. 

If we assume, as discussed earlier, that the pedestrian environment is intended for 
'normal, healthy adults in their prime, 1 then these are people of 'normal stature and 
dimensions' with 'normal perceptions and reactions' with 'normal agility and stamina' and 
whose physical equipment can cope with pedestrian activities with little difficulty. The 
remainder of the population is, therefore, by this definition, handicapped as pedestrians. 
Their dimensions, agility, reactions and bodily equipment are impaired or inadequately 
developed to operate as a pedestrian in the present environment without difficulty or 
greater than normal danger. 

We can then specify the performance levels of the main physical and mental attributes 
necessary for 'normal pedestrian movement,' and conclude that unless the levels are 
reached, the subject is handicapped. We can classify them into the following 
handicapped groups relating to: 

a) Size and maturity 

b) Agility, stamina and reaction time 

c) The use of their legs 

d) Their arms, shoulders and neck 

e) Their hearing 

f) Their sight 

g) Their mental condition. 

Statistical information is available to enable us to further sub-divide those with lower 
extremity impairments into three groups, and those with developmental restrictions into 
two groups. Using this method, we have developed a classification of ten subgroups, as 

shown in Table 8. 



46 



Table 8: Classification of Handicapped Groups 



' Attribute 


Handicap 


Sub-Group ^ 


A. Size and 
maturity 


Developmental 
restrictions 


1. 
2. 


Pre-school children 
School-age children 


B. Agility, stamina 
and reaction time 


Chronic restrictive 
conditions related to 
agility, stamina, and 
reaction time 


3. 


Persons over 65 


C. Legs 


Lower extremity 
impairment 


4. 
5. 


Confined to wheelchair 

Walking using special 
aids 






6. 


Walking with difficulty 
without the use of 
special aids 


D. Arms and shoulders 


Chronic impairment of 
upper extremities and 
shoulders 


7. 


Chronic impairment of 
upper extremities and 
shoulders 


E. Hearing 


Severe auditory impair- 
ment 


8. 


Severe auditory impairment 


F. Sight 


Severe visual impair- 
ment 


9. 


Severe visual impairment 


G. Mental condition 
V 


Obvious confusion, 
and/or disorientation 


LO. 


Obvious confusion and/or 
disorientation 

J 



Some further explanation of this classification system is necessary. 

Subgroup A— Size and maturity 

This group includes all those whose size is smaller or larger than the average able 
bodied adult. Members of this group may not be able to reach most handrails, pay 
telephones, etc.; and cannot easily use steps and stairs because their legs are too short; 
and, because of their small stature, they will be less visible to vehicle drivers. 

We also must include those who are too large, for whom there is often insufficient 
headroom; or because of obesity or advanced pregnancy, need more space than usual. 

47 



And we include here development immaturity in terms of childish behavior; the inability 
to discriminate sufficiently between dangerous and safe activities, to exercise 
forethought in using the pedestrian environment alone, and to cross vehicular roads 
without assistance, for example. 

Typically, we find in this group pre-school and school age children, dwarfs, giants, obese 
people, women in advanced stages of pregnancy, etc. This is not an exhaustive list. It 
is not difficult to derive estimates of the population of children, but very much more 
difficult to identify reliable figures for the other members of this group. Therefore, 
only the figures for pre-school and school age children have been estimated. 

Subgroup B— Agility, stamina and reaction time 

This group includes those whose difficulty in negotiating the pedestrian environment is 
derived from a substantially reduced degree of agility, stamina and reaction time. 
Members of this group may have particular difficulty in crossing the street in the time 
allotted by the traffic signals; they may be unable to travel more than a short distance 
without the need to sit or to rest; they may react dangerously slowly to oncoming 
vehicles; they may have arthritic or stiff joints which make it difficult for them to 
climb steps, operate door knobs, etc. 

Typically, these are degenerative conditions that accompany the normal process of 
aging, and the predominant group is those who are elderly— those who are 65 and over. 
These conditions may, of course, be present in people of any age; however, because 
adequate data on these people is not available, for the purposes of this study, population 
estimated on the former group only, have been obtained. 

Subgroup C~-Lower extremity impairment 

This group includes those with a wide variety of lower extremity impairments and can 
conveniently be subdivided into three sections for which statistical data is available. 

Wheelchair users 

Many medical conditions may limit a person to the use of a wheelchair for moving from 
place to place, and medical considerations control the type of wheelchair used. The 
most important of these is whether the subject has powerful upper limbs and can propel 
the wheelchair freely over flat ground. If this is feasible, then the chair user should be 
able to negotiate most pedestrian ways except stairs and very rough or soft ground. If 
the user does not have powerful upper limbs, then an attendant may be required to push 
the wheelchair, or an electronic motor to drive it. 

If there is an attendant, then it is obvious that much of the work usually performed by a 
wheelchair user with powerful arms is compensated for by the attendant, and indeed, 
the attendant might perform other services as well. 

The most common medical condition where the patient retains powerful upper limbs and 
can manipulate a wheelchair but cannot walk, is paraplegia, a spinal cord injury that 

48 



paralyzes below the waist. These people may drive hand operated cars, managing to get 
in and out of their car, collapsing their wheelchair and lifting it into the back seat. 

Other types of conditions occur where the upper limbs are capable of manipulating a 
wheelchair, e.g., traumatic conditions involving only the lower limbs, arthritis involving 
only the lower limbs, and poliomyelitis. 

People with severe brain damage, e.g., cerebral palsy, stroke, multiple sclerosis, may 
depend entirely upon attendants or electric motors with minimal control necessary by 
the patient, for propulsion. To operate electric motors, a quadriplegic who has had 
injury to the spinal cord in the neck region must, at least, have the use of an upper limb 
in order to control the joystick of his machine. However, a limited number of people 
have now been provided with devices that are controlled by transducers in the facial 
region that can be controlled by blowing, eye movement, head movement, etc. 

Walking using special aids 

This subgroup includes people with impairments of the lower extremities which severely 
handicap them but do not mandate the use of a wheelchair. It implies that these people 
can use their own lower limbs with the supplement of special aids. These include braces 
(both long and shortleg braces), prostheses ("artificial legs"), and crutches for both 
support and propulsion. People who use canes for support are not included in this group. 

Leg Braces . The majority of bracing of the leg that still permits walking involves 
paralysis due to diseases and injuries of both the central nervous system and the 
peripheral nervous system. With injury or disease of the brain and spinal cord, many 
people are so severely disabled that they can never walk at all, but many others are able 
to do so with braces to maintain the knee joint and the ankle joint in a firm embrace, 
prohibiting collapse of these joints. With the stiffening provided, these people are 
capable of swinging their limb and producing a modified gait which is, in spite of its 
much greater demand of emotional and physical effort, successful in propelling them for 
distances varying from a few paces to possibly several miles. Such people have some 
difficulty in negotiating stairs in and out of buildings as well as in public transportation 
situations. However, many drive cars daily. 

Conditions in which the above circumstances obtain include the following: 

a. Central Nervous System . 

Stroke (cerebrovascular accident) where the paralytic condition is usually confined 
to half the body (hemiplegia) and is complicated by involvement of the upper limbs 
and sometimes speech and cognition even in the ambulant patient. A further 
complication is the existence of spacticity which makes the paralysis even more 
awkward. 

Cerebral Palsy often consists of gross disturbance of locomotion which may be 
complicated with gross abnormalities of upper limb function, and, in many cases, 
with mental retardation. Where locomotion is possible with special aids, these are 

49 



normally canes or braces. Their functions are to support the body during gait. 

Infections (e.g., brain abcesses, encephalitis). These may result in problems 
similar to the above (hemiplegia) or more severe involvements. Recovery may be 
complete; however, some patients will have limitations similar to those noted 
above for the stroke patient. 

Multiple Sclerosis and Related Spinal Cord Diseases . This group of diseases are of 
obscure etiology. Many of them are progressive and the victim passes from a 
period of slight impairment to very severe impairment. In the interval, many such 
patients manage to walk with bracing of their lower limb to prevent collapse of 
the major joints because of muscle weakness. 

b. Peripheral Nervous System . 

Poliomyelitis, until the 1960's a cause of many patients requiring lower limb 
bracing, now affects very few new cases this way. However, there are many 
thousands of Americans who manage to go about their daily business with small to 
large metallic bracings of their lower limbs (one or both). Some of these people 
walk with a slight limp; others have considerable difficulty in walking and 
supplement their bracing with canes and crutches. 

Peripheral Nerve Injuries and Diseases . Inflamation of nerves (neuritis) may result 
in temporary or permanent paralysis of the lower limbs and require treatment by 
bracing similar to what has been mentioned. Nerve injuries due to trauma would 
have the same effect. 

Neurological conditions may require the victim to walk with the aid of a cane or 
canes as support for the weak limb or limbs. This support compensates for the 
mild to moderate weakness. If the limbs are very weak, crutches are used as the 
prime swingthrough lever. With both crutches and canes, the patient may require 
bracing as well. Again, the involvement of other parts of the body may dictate 
whether the whole approach is feasible. 

c. Bones, Joints and Muscles . 

Traumatic Conditions . Accidents can produce all of the disabilities in locomotion 
that nerve damage can produce. In addition to instability, however, accidents can 
produce severe restrictions of motion where the hip joint and/or knee joint and/or 
ankle and foot will not move in the proper sequence. Further, severe pain may 
restrict mobility and speed of movement. Braces are used to attempt to 
compensate for all of these problems. If the condition is an acute one, instead of 
braces, plaster casts are employed as a temporary device. People in splints and 
plaster casts usually must also have canes or crutches and their range of 
limitation varies from barely mobile to aggressively active. 

Arthritic Conditions . Two major subdivisions of arthritis affect the public- 
rheumatoid arthritis and osteoarthritis. The former is common in middle age and 

50 



the latter becomes progressively more disabling in older people. Almost all 
elderly people have some degree of osteoarthritis and many are severely disabled 
by it. Not only is pain in major joints an important deterrent to walking, but also 
the joints become progressively stiffer and unresponsive so that the patient is 
slowed down by both physical restrictions and fear of pain. Braces are seldom 
used in such conditions, but canes and crutches are a commonly used resource for 
the patient with arthritis. 

Environmental Conditions and Boundaries Affecting Patients in Subgroup 5 

For all people who walk with special aids, the environment is most favorable where it is 
flat, not slippery, and provides for safe rest stops and maximum assistance in 
counteracting gravity (elevators). It is most threatening where the ground is slippery, 
rough, includes stairs as the only method of ascent and descent, and is hostile to those 
who must stop and rest often (e.g., crossing a wide street or negotiating passage through 
a milling crowd). Fatigue is an obvious problem for all such people. The pace of normal 
activity in getting in and out of private transportation and public transportation is 
usually much slower. 

Walking with difficulty using canes or walking sticks 

The conditions mentioned in Subgroup 5 all obtain in Subgroup 6, along with some other 
mild problems of secondary importance; it is just a matter of degree. Some people 
prefer not to use braces or crutches. Others have had inadequate medical care or 
simply cannot afford the devices. Many persons in the latter group may be as severely 
disabled as patients in Subgroup 5, and probably could benefit from the use of special 
aids. 

Subgroup D— Chronic impairment of upperneck and shoulders 

The medical conditions that produce chronic impairments of the upper extremities and 
shoulders embrace the same systems and disease processes that affect the lower 
extremities. Impairment of grasp, and pain during elevation of the limb while 
manipulating handles, etc., are typical manifestations. And the problem is magnified 
when it is accompanied by serious lower limb impairments. 

Many parts of the environment are controlled by objects that require handling before 
one can proceed. These objects have been designed for 'normal' people with sufficient 
muscular strength to press up or down on a bar, to turn a handle, to manipulate with 
precision; and this requires the ability to grasp and the pronation/supination of the 
forearm. And in many cases, the devices are overhead, where the subject cannot reach 
them because of weakness or pain. 

Subgroup E— Severe auditory impairment 

Severe auditory impairment to the point of 'deafness' arises from many conditions 
involving diseases of the middle ear and the inner ear 'neural deafness.' Middle ear 
deafness is decreasing in importance in America because its most common source is 

51 



infection, particularly in childhood. Nevertheless, it still occurs among the poor. Its 
final influence on citizens negotiating the environment is no different than neural 
deafness. The cause of neural deafness is not precise, many cases being considered 
•idiopathic 1 (no known cause). While deafness can be compensated for by hearing aids, 
some frequencies in the sound cycle are not properly transmitted to the brain through a 
hearing aid. 

The degree of hearing loss is important here because, obviously, there is a relationship 
between the severity of the impairment and the handicapping effect. As discussed 
later, the statistics used for this report are based on the Health Interview Survey for 
the Bureau of the Census. And this survey differentiates between monaural and 
binaural hearing loss and between persons who: 

• cannot hear and understand spoken words 

• can hear and understand a few spoken words 

• can hear and understand most spoken words. 

For the purposes of this study, only people with binaural hearing loss have been counted, 
and only people in the first two categories above. 

Subgroup F— Severe visual impairment 

Visual impairment at any level can occur because of disease of the eye in childhood. In 
later life, inflammatory conditions due to infection and unknown causes can cause visual 
impairment. Probably the most severe visual impairments can occur at any age and can 
be classified as errors of refraction. Fortunately, these errors of refraction can be 
compensated for in most people with proper lenses. The truly severe visual impairments 
that pose a danger to the individual are those which approach blindness in the legal 
sense. Cataract, which is common among the elderly is a clouding of the lens of the 
eye. It requires surgical removal of the density from the lens after which the patient 
must wear special lenses. However, in spite of the excellent treatment of cataract, 
elderly patients wearing their thick lenses after cataract surgery are severely annoyed 
by the fact that they cannot see what lies at their feet as they walk. 

As with many disabilities, the severity of the impairment varies and the handicapping 
effect also. As discussed later, for this study, it is necessary to differentiate between 
monocular and binocular impairment. For the purposes of this study, only those with 
binocular impairments were counted, and of these, only those 'who cannot see features 
or moving objects. 1 

Subgroup G— Obvious confusion or disorientation 

At any age, organic or mental conditions may lead to obvious confusion, mental 
disequilibrium, and/or disorientation. These conditions can arise from immaturity, 
mental illness, organic brain conditions, alcoholism, drug intoxication, and neuroses. 
Mental retardation is widespread, and an I.Q. below 35 implies an intelligence of a small 

52 



child in the body of someone who might be quite adult physically. At the other end of 
the scale, the term 'senility' is often used to define mental deterioration. This is due to 
organic degeneration of brain cells with increasing age. Alcohol and certain drugs, 
many of the latter being prescription drugs given by treatment of some condition in the 
patient, grossly reduce the performance of people in the environment; and many persons 
under the effect of alcohol, hard drugs, and prescription drugs for treatment, do not 
appreciate their reduced performance and judgement level. 

The pedestrian environment makes very little allowance for those citizens who venture 
into it with less than normal reflexes, normal intelligence, normal reaction time, and 
normal judgement. Many such persons cannot understand signals, let alone read signs, 
while the switch to signs that employ symbols is a slight improvement; their major 
advantage is the speed of comprehension by normal people. Symbols are often just as 
difficult for the mentally ill and mentally incompetent to understand as written words 
are. 

risk population— among pedestrians 

Introduction 

By definition, a pedestrian is an individual traveling on foot. Excluding those who drive 
or ride motorized or non-motorized vehicles, there are other users of the road besides 
able-bodied pedestrians. 

There are also those who, to some degree, lack the ability to walk as easily as a 
supposedly normal person. These people move with some difficulty with or without Any 
aid, mechanical or otherwise, and this difficulty is commonly regarded as disabling. 

The present investigation is designed to determine the risks and problems experienced 
by this latter group in pedestrian locomotion. 

Ambulation has attendant risks, with characteristic differentials to disparate groups of 
people in different places. Any attempt to measure these differentials should logically 
be dependent upon a proper identification of these groups and estimates of their 
numbers. It is only after such an undertaking has been completed that subsequent 
estimates of proportions among these different categories in different locations can be 
derived. The present investigation deals primarily with the estimates of group numbers. 

Population at Risk 

To identify the different categories among the population characterized by differentials 
in the risks involved in locomotion, it was felt that certain significant categories of 
disabilities should be examined separately. The possibility of somewhat higher risks 
among older and younger population, disabled or not, as well as among those who are 
mentally unstable, (as discussed earlier) was also recognized and it was agreed to obtain 
statistics for the following ten subgroups: 



53 



1. Preschool children (population under 6 years of age). 

2. School-age children (population 6-17 years of age). 

3. Older people (population 65 years and over). 

4. Wheelchair users. 

5. Walking with special aids (artificial arm or leg, braces, crutches, special shoes, 
walker, etc.). 

6. Walking with difficulty (use cane or walking stick). 

7. Chronic impairment of upper extremities and shoulders. 

8. Severe auditory impairments (cannot, or have difficulty in hearing or under- 
standing spoken words). 

9. Severe visual impairments (legally blind and those who can read newsprint but 
cannot see features and/or moving objects). 

10. Obvious confusion and/or disorientation (including alcoholism, drug dependence 
and mental illness). 

The first three are merely age categories, and from that point of view are mutually 
exclusive among themselves. The remaining seven represent types of disabling 
conditions which significantly impede a person's ability to move around, and in fact, are 
the most prevalent of the disabling conditions. Obviously, a person may suffer from 
more than one disabling condition, and therefore these categories are not mutually 
exclusive among themselves. This fact is worth noting since an estimate of the numbers 
of disabled population cannot be obtained simply by adding the estimates of the 
individual disabling conditions. 

Estimates by Categories 

The U.S. Department of Health, Education and Welfare (DHEW) conducts periodical 
surveys of non-institutional populations through random samples of households, for 
estimating the composition of population by various disabling conditions and other 
associated variables, some of which are used for cross-classification. Tables with short 
reports are published in Vital and Health Statistics. Data from the National Health 
Survey of DHEW reports (for subgroups 4-9) and the 1970 Census report (for subgroups 
1-3) and other publications (for subgroups 9 and 10), were used to generate estimates of 
subgroup totals shown in Table 9. 

These estimates (Col. 2) refer to different time periods and therefore correspond to 
different base populations. Estimates for the calendar year 1975 (Col. 3) have been 
obtained by assuming that the respective disability rates have remained the same during 
this period. In other words, the figures in Col. 2 are multiplied by the ratios of 

54 



population size in 1975 to those in the base periods of respective estimates, to generate 
Col. 3 (see Appendix D for population composition by sex, age and rural-urban areas for 
1970). 

From Table 9, and at the risk of double counting, the disabled population in 1975 can 
thus be estimated as over 12 million. In percentage terms, the figure is of the order of 
6 percent, and surprising as it may seem, it is apparent that one out of every 16 or 17 
persons in the U.S. has a major handicap which acts as a deterrent to locomotion. 



Table 9: Estimated Distribution of Risk Population by Major Groups 



c 

DESCRIPTION 
OF GROUPS 
(Col. 1) 


ESTIMATED 
POPULATION 
(000) 


NUMBER 
PER 1,000 
POPULATION 
(Col. 4) 


Around 
1970 
(Co. 2) 


Around 
1975 
(Col. 3) 


1. 


Preschool 
Children 
(under 6) 


20,965 a 


20,926 


97.50 


2. 


School-age 

Children 

(6-17) 


48,679 a 


46,482 


216.57 


3. 


Older people 
(65 and over) 


20,065 a 


22,170 


103.30 


4. 


Wheelchair users 


409 b 


445 


2.07 


5. 


Walking with special 
aids 


4,638 b 


5,042 


23.49 


6. 


Walking with difficulty 


2,156 b 


2,344 


10.92 


7. 


Chronic impairment 
of upper extremities 
and shoulders 


2,440 c 


2,588 


12.06 


8. 


Severe auditory 
impairment 


l,592 d 


1,867 


8.70 



55 



Table 9: Estimated Distribution of Risk Population by Major Groups 
(Continued) 

9. Severe visual 475 e 482 2.25 

impairment 

10. Obvious confusion 20,000 f 20,000 93.19 

and disorientation 

SOURCES: a See U.S. Summary: General Population Characteris- 
tics , Vol. 1, Pt. 1, Tabtes 50, 52 and 53, U.S. Census, 
Washington, D.C., 1970. 

See Vital and Health Statis tics, DHEW Washington, 
D.C., Series 10, No. 78, 1969. 

c See DHEW, Series 10, No. 87, 1971. 29 

d See DHEW, Series 10, No. 35, 1964. 30 

e See DHEW, Series 10, No. 46, 1963-1964; 31 Hatfield, 
E.M., "Estimates of Blindness in the United States," The 
Sight-Saving Review , Vol. 43, #2, 1973, pp. 69-867*^ 
Also see unpublished report of the National Society for 
the Prevention of Blindness, Inc., January, 1975. 

f 
Partial Reference list includes: 

1. Mudford, H.A., Drinking and Deviant Drinking, 
U.S.A., 1963, Quarterly Journal of Studies on 
Alcohol , V. 25, 1964. 

2. Eddy Nathan, H. Halbach, I.H. Isbel and M.H. 
Seevers, "Drug Dependence: Its Significance and 
Characteristics", Bulletin WHO , Vol. 32, 
1965.^ 

3. Martindale, D., and E. Martindale, The Social 
Dimension of Mental Illness, Alcoholism and 
Drug Dependence . Glenwood Publishing Com- 
pany, 1973. 

4. Also see Section f under Joint Distributions of 
this report, and Appendix I of this report. 



56 



Adjustments for Multiple Handicaps 

It has been noted before that the estimates shown in Table 9 are not additive because a 
person suffering from more than one disabling condition will be counted more than once. 
Unfortunately, tables showing the distribution of population with one, two, etc., 
disabling conditions are not available and therefore a reasonable estimate of the 
numbers of the disabled population cannot be made. From the description of the 
disabling conditions, however, it seems appropriate to introduce the assumption of 
independence for categories 4 through 9, so that the proportion of the population with a 
condition, say A, is independent of whether the person has or has not another condition, 
B. Accordingly, if the proportion in the population that has A is denoted by a, and the 
proportion that has only A is denoted by (a), and with similar definitions for b and (b), ab 
and (ab), etc., one can write the following equations: 

(a) = a(l-b) (1-c)... 

(b) = (1-a) (1-c)... 

The estimates of a, b,...etc, for 1975 can be obtained from Table 9 (Col. 4) by moving 
the decimal point three places to the left. Writing: 

K = (1-a) (1-b)... (2) 

(1) can be rewritten as 

(a) = K a 

1-a 

(3) 

(b) = K a 

1-b 

and 

(ab) = K a (4) 

(1-a) (1-b) 

For values of a, b,...given in Table 9 (Col. 4), K = .94181, from which values of (a), (b), 
(ab),...can be obtained from (3) and (4). For example, to find the number per thousand 
population who had the only disabling condition affecting their upper extremities, we 
multiply the number per thousand population having that as at least one of their 
disabling conditions, namely 12.06 (so that: (a) = .01206, see Table 9) with exactly two 

(2) disabling conditions, say, problems with upper extremities as well as auditory 
impairments, for which (b) = .00870, we multiply 11.53 by .870/ (1 - .00870) to get .10, 
etc. 

Disability Rates by Mutually Exclusive Categories 

It may be noted that in the given example, values of a, b,... are small, so that the 
proportions of the population with three or more conditions are virtually negligible. 

57 



Consequently, without significant loss of accuracy, the joint distribution of disabilities 
can be formulated in terms of a two-way table (Table 10) in which the diagonal 
elements represent the proportion of the population affected by only one condition and 
the others by two conditions described by the appropriate row and the column. These 
latter proportions are derived from (4) and the diagonal elements are obtained so that 
the sum of a given row or column corresponds to the given values of a, b,... in Table 9, 
Col. 4. This way, proportions with three or more conditions will be merged with those 
with only one condition and hence the relative error will be eliminated. 

Table 10: Number Per 1000 Population Corresponding to One and Two 
Disabling Conditions* 



r 

Conditions 


Wheel- 
chair 


Walking 

with 

Aids 


Walking 

with 

Difficulty 


Upper 
Extrem- 
ities and 
Shoulders 


Auditory 
Impair- 
ment 


Visual 
Impair- 
ment 


(Col.l) 


(Col. 2) 


(Col. 3) 


(Col. 4) 


(Col. 5) 


(Col. 6) 


(Col. 7) 


Wheelchair 


2.03 
(434) 


.00 


.00 


.02 


.02 


.00 


Walking with 
Aids 


.00 


22.99 
(4933) 


.00 


.26 


.19 


.05 


Walking with 
Difficulty 


.00 


(.00) 


10.69 
(2294) 


.12 


.09 


.02 


Upper Extrem- 
ities and 
Shoulders 


.02 
(4) 


.26 
(56) 


.12 
(26) 


11.53 
(2475) 


.10 


.02 


Auditory 
Impairment 


.02 
(4) 


.19 
(41) 


.09 
(19) 


.10 
(21) 


8.29 
(1779) 


.02 


Visual 
Impairment 


.00 
(1) 


.05 
(11) 


.02 
(4) 


.02 
(4) 


.02 
(4) 


'2.13 
(457) 


Total 


2.07 


23.48 


10.92 


12.05 


8.71 


2.24 


♦Estimated i 
parentheses 


lumber (i 

• 


n 000) ai 


^e for the ; 


/ear 1975 i 


ind are sr 


own in 

J 



58 



For reasons of simplicity, all six categories (4-9) were treated in the same manner. 
However, from a common sense point of view, categories 4-9 can be regarded as 
mutually exclusive. Accordingly, the proportions corresponding to any pair of these 
categories were merged with the respective diagonal element in Table 10. 

The sum of the diagonal elements (reading from top left to bottom right) is 12,372, and 
this provides an estimate of the population suffering from only one disabling condition 
which for the year 1975 is about 12.4 million. The elements beneath the diagonal of the 
matrix add up to 195 (000's) or about one-fifth of one million, which, on the one hand, is 
the estimated size of the population suffering from more than one disabling condition, 
and is the amount of error due to double counting in the total of Col. 3 of Table 9, on 
the other. The sum of these two numbers, or 12.5 million (which is the sum total of 
mutually exclusive categories of disabling conditions) can therefore be regarded as an 
estimate of the size of the disabled population in the United States in 1975. 

The same priniciple of decomposition can be used on any subgroup of population (e.g., 
sex, age, race, place of residence, etc.). Unfortunately, rates are not available for all 
disabling conditions broken down into a uniform set of age categories. However, a 
rough estimate of the decomposition of the 12.5 million disabled population can be 
obtained by noting that among those in the 18-64 age category, numbers per 1000 
population using wheelchair, and those with severe auditory and visual problems are 
approximately 20, 6.3 and 1, respectively (derived from Tables 11-15). In round 
numbers, the disabled population in the age category 18-64 can be estimated at 3 
million. The balance of 9.5 million suffering from one or more disabling conditions are 
either young or old, and as such, comprise a significant proportion of the 89.5 million in 
those age categories. The difference between these two numbers, namely 80 million, 
represents that portion of the young and old population that are not disabled, but by 
virtue of their age, represent a different kind of risk population. 

Joint Distributions 

The discussion in the previous section has dealt specifically with categories 4 through 9, 
and estimates are derived separately for each disability, and jointly for a pair of 
disabilities. Categories 1 through 3 refer to selected age groups that are not mutually 
exclusive for the remaining groups. In many cases, it will be of interest to obtain 
disability rates specific for age, and other variables like sex, race, region, urban-rural 
residence, socioeconomic status groups, etc. The list of such cross-classifications can 
be made virtually endless; however, in a given instant of time, such inquiries have to be 
limited by the data that are available. The following summary is therefore provided for 
the benefit of readers who are interested in finding out the breadth as well as the depth 
of the volumes of data that are available in this area and data that have been tabulated, 
analyzed and published. 

a. Age (Categories 1-3). The distribution of population by age is available by single 
years of age (which can then be conveniently grouped) cross-classified further by 
sex, race, geographic region, state and many other variables. Distributuions for 
these categories are available for the year 1970 in the Census reports. Intercensal 
estimates or short-term projections can also be made at the national level with 

59 



considerable reliability. However, regional estimates, say for the year 1975, and 
similar other estimates, have to depend on intergroup population movements, and 
additional assumptions are required to measuare those variables. Ordinarily, such 
assumptions are required to measure those variables. Ordinarily, such assumptions 
are made in relation to their distributions in census years. To give an example, 
consider the Census Bureau's projection of the U.S. population for the #pars 1975, 
1980, etc., with four different assumptions of the trend of fertility. One can 
average those trends or use any of the four projections, but additional assumptions 
are required when one has to distribute these national projected estimates by, say, 
place of residence. Thus, Table 11 can be obtained by assuming average fertility 
as well as constancy of urban to total population in all age-sex groups for the 
period 1970-75. In this example, the latter assumption may be justified since its 
application is not extended beyond a short period of time. However, operational 
simplicity should not be the principal determinant where a different approach is 
indicated by a prior information. 

Table 11: Projected Age-Sex Composition of Population by Place 
of Residence: U.S. 1975 



r 

Age 
(Col.l) 






Population (000) 




"^ 


Urban 


Non-Urban 


Tc 


(Col.2) 
M 


(Col.3) 
F 


(Col.4) 

M 


(Col.5) 
F 


(Col.6) 

M 


(Col.7) 
F 


Under 6 


7,759 


7,445 


2,932 


2,790 


10,691 


10,235 


6-17 


16,733 


16,288 


6,934 


6,527 


23,667 


22,815 


18-24 


10,941 


10,779 


3,126 


2,935 


14,067 


13,714 


25-44 


19,664 


20,267 


6,956 


6,947 


26,620 


27,214 


45-64 


14,955 


17,010 


5,665 


5,801 


20,620 


22,811 


65 and 
over 


6,324 


9,867 


2,746 


3,233 


9,070 


13,100 


TOTAL 


76,376 


81,656 


28,359 


28,233 


104,735 


109,889 


Sourc< 


j: U.S. Bv 
Series P 


ireau of C 
25, Nos. 


ensus; Current Pop 
311, 483 and 493. 


ulation Re 


sports 

J 



In a similar fashion, population estimates for other classification categories can 
be derived. For example, an estimate of the number of urban males 65 years of 
age or older with severe visual impairment can be obtained by multiplying the 
estimated population size by the corresponding rate. Since any cross-classifica- 



60 



tion like that shown in Table 11 has to be obtained from similar tables for the year 
1970 with appropriate assumptions, a few summary tables from the 1970 Census 
reports are represented in Appendix D. 

b. Users of Special Aids (Categories 4-9). According to a household survey (a 
national sample of about 42,000 households covering 134,000 persons) conducted 
by the DHEW in 1969, more than six million persons were estimated to be using 
special aids for getting around. This accounted for over 3 percent of the total 
population. The distribution by selected age-sex categories is shown in Table 12. 



Table 12: Age-Sex Specific Rates of People using Special Aids* 

(Expressed as Percentages of the whole population) 



r 

Sex 


Under 
15 


15-44 


45-64 


65 and 
over 


All Ages 


(Col.l) 


(Col. 2) 


(Col. 3) 


(Col. 4) 


(Col. 5) 


(Col. 6) 


Male 
Female 


2.6 
1.8 


1.5 
0.7 


3.6 
2.9 


12.4 
13.4 


3.4 
3.0 


♦Artificial arm, artificial leg, brace of any kind, crutches, cane 
or walking stick, special shoes, wheelchair, walker, or any kind 
. of aid for getting around were the nine items used in the list. 



Persons 15-44 years of age reportedly had the lowest percentage of the population 
using aids and persons 65 years and over reportedly had the highest. It may be 
noted that the percentage of use of aids for the latter group was about four times 
greater than that of the next lower age group, namely 45-64 years. A few 
important cross-classifications for the users of special aids are shown in Appendix 
E. 

c. Impairment of Upper Extremities and Shoulders (Category 7). Impairment, as 
defined by DHEW, is n a chronic or permanent defect, disabling or not, 
representing for the most part decrease or loss of ability to perform certain 
functions, particularly those of the musculoskeletal system and special senses." 
Data on various kinds of impairment were obtained during 1971 from a random 
sample of about 42,000 households containing some 134,000 persons. Impairment 
of upper extremities and shoulders was found to have a prevalence of 
approximately 12.1 per 1,000 population. This category was isolated because of 
the visibility, in most cases, of such an impairment, whereas the users of special 
aids are visible primarily because of the aids they use, and only secondarily by 



61 



their disabling conditions. Since DHEW is more interested in impairments in 
general, and causes of impairments in particular, distributions of population with 
this condition are available only for a limited number of characteristics (see 
Appendix F), where injury of some kind was the cause of such condition. 

d. Severe Auditory Impairment (Category 8). Information about persons with 
impaired hearing was obtained from a supplementary questionnaire mailed to 
those persons for whom hearing impairment was reported during an interview 
conducted by the Bureau of the Census in 1962-63 for the Health Interview 
Survey. As with other similar surveys, the data were collected from a continuous 
probability sampling of the civilian, noninstitutional population of the United 
States. This particular sample consisted of some 42,000 households containing 
about 134,000 persons. For the purpose of the report, severity of hearing 
impairment is of interest when it excludes persons with hearing impairment in 
only one ear. Among persons with hearing impairment in both ears (binaural), the 
DHEW report makes the following distinction among persons who: 1) cannot hear 
and understand spoken words; 2) can hear and understand a few spoken words; and 
3) can hear and understand most spoken words. 

Even though the distinction between the last two subgroups is based on some 
arbitrary dividing line, it was decided to combine the first two subgroups to 
generate the category of "severe auditory impairments." During the reference 
period (1962-63), 1.6 million persons were found in this category, and Table 13 
records the distribution and rate per 1,000 population by sex and broad age 
categories. 



Table 13: Distribution of Persons with Severe Auditory Impairment by Sex 
and Age and of Rates Per 1,000 Population 



r~ 


Age 


Number of Persons 
With Impairment 


Rates per 1000 Persons 
With Impairment 




Male 


Female 


Total 


Male 


Female 


Total 


(Col.l) 


(Col. 2) 


(Col. 3) 


(Col. 4) 


(Col. 5) 


(Col. 6) 


(Col. 7) 




Under 17 years 


46 


42 


88 


1.3 


1.4 


1.4 






17-44 


105 


112 


217 


3.5 


3.4 


3.4 






45-64 


243 


185 


428 


13.5 


9.7 


11.5 






65 and over 


403 


456 


858 


53.7 


48.7 


50.9 






All ages 


827 


794 


1,592 


9.0 


8.4 


8.7 


) 



62 



Distributions are also available by family income, number of years completed in 
school, race, and residence, and also for the four regions of the country, each 
classified by age. These tables are shown in Appendix G. 

e. Severe Visual Impairment (Category 9). 

Information about visually impaired persons was also collected by DHEW during a 
52-week period and the sample was so designed that interviews were conducted 
every week during the period for this survey (July 1963 to June 1964). This 
sample was also composed of approximately 42,000 households consisting of about 
134,000 persons. In identifying vision problems, no attempt was made in the 
survey to equate blindness in the legal sense, because a visual acuity test is basic 
to the legal definition of blindness: ' "A person shall be considered blind whose 
central visual acuity does not exceed 20/200, has a limit to the field of vision to 
such a degree that its widest diameter subtends an angle of not greater than 20 
degrees." 

A detailed classification of visually impaired persons (6 years and over) was, 
however, developed using data obtained from the questionnaire designed for this 
survey. These were: (a) both eyes involved; (b) one eye involved; and (c) unknown 
if one or both eyes involved. The first group was of primary interest and was 
further subdivided into two categories—persons who cannot read newsprint and 
persons who can read newsprint. Further subdivisions were also made to elicit as 
much information as possible (e.g., can or cannot see features, moving objects, 
and light). A summary of the estimates of visually impaired population in a 
number of subgroups is shown in Table 14. For practical reasons children under six 
years of age were excluded. 

Females reported an overall higher rate of vision impairment than did males. The 
reasons for this significant difference are not known. However, increase in rates 
of impairment with age is in the expected direction. Additional cross- 
classifications with respect to income, education, region, race and place of 
residence (urban, rural nonfarm and rural farm) are shown in Appendix H. Persons 
in lower income brackets with less than 9 years of education reported considerably 
higher rates of vision impairment. Rates for nonwhites, as well as for 
southerners, were found to be higher; the lowest rates were found among persons 
living in standard metropolitan statistical areas. 

Summarizing the results, almost one million persons, 6 years of age and over, 
during the reference period 1963-64, were found to have impairments in both eyes 
to the extent that they could not read newsprint. However, this provides an upper 
boundary of the estimated number of persons with severe visual impairments since 
more than two-thirds of these people could see features and moving objects. On 
the other hand, there were a few who could read newsprint but could not see 
features. From the point of view of pedestrian-related problems, one may argue 
that the relevant subgroup should consist of those who cannot see features or 
moving objects. 

63 



The size of this category was approximately 300,000, and assuming that the 
increase in size during the following year was proportional to that in the general 
population, the estimate for the year 1975 will be approximately 375,000. This 
estimate should be regarded as the lower boundary of the group that is 
characterized by severe visual impairment and, on comparing with the 1974 
estimate (furnished by the National Society for the Prevention of Blindness) of 
475,000 people who are legally blind, it was felt that the latter estimate is 
reasonable (see Appendix H, Table 38). 



Table 14: Number of Visually Impaired Persons (1000) with Both Eyes Involved 
by Degree of Impairment, Sex and Age 
U.S. July 1963 - 1964 



( 












\ 


Degree of Impairment 


Male 


Female 


All 


6-44 


45-64 


65+ Years 


(Col.l) 


(Col.2) 


(Col.3) 


(Col.4) 


(Col.5) 


(Col.6) 


(Col.7) 


Cannot see Features 














and/or Moving 
Objects 


121 


189 


310 


33 


57 


221 


Cannot read 














Newsprint 


108 


179 


287 


30 


50 


207 


Can read 














Newsprint 


13 


10 


23 


3 


7 


14 


Can see Features 














and Moving 
Objects 


878 


1,468 


2,346 


408 


657 


1,280 


Cannot read 














Newsprint 


240 


442 


682 


67 


142 


472 


Can read 














Newsprint 


638 


1,062 


1,664 


341 


515 


808 

) 



f. Obvious Confusion and/or Disorientation (Category 10). 

Data for this category are most difficult to find since the basic characteristics of 
the population with these conditions cannot be adequately defined. For this study, 
it was decided to use three groups of people: those who are a) alcoholics; b) 
dependent on drugs; and c) mentally ill (see Appendix I). 

64 



Although various researchers have studied these three problem areas, reliable 
estimates of the population corresponding to these conditions are not available. In 
round numbers, a figure of 20 million has been accepted and shown in Table 9, 
without any attempt at further decomposition. 

Discussion of Results 

For the ten categories of the disabled population, projected estimates for the year 1975 
(Table 9) provided the basic input which was later decomposed into mutually exclusive 
categories that provided some insight into the procedure for estimating the size of the 
disabled population. Fortunately, when the assumption of independence held, the 
amount of double counting was found to be small (around two percent), because the 
incidence rates of the various disabling conditions were also small in magnitude. As a 
result, it was found virtually unnecessary to make adjustments for cases involving more 
than two disabling conditions. 

The detailed distributions available for each condition were later examined in terms of 
their variety, uniformity and usefulness. The users of this particular study may be 
frustrated by lack of data; however, in most cases the basic data that are available in 
the source materials can be used to generate required distributions with appropriate 
assumptions, at least in certain cases. As an illustration, the distribution of population 
by sex can be generated from Col. 3, Table 9, by applying the proportions noted for each 
sex in the base years. Table 15 can then be obtained. 



Table 15: Estimate of Disabled Population (000) by Sex 
United States, 1975 



Disability Type 


Percent 


Estimated Disabled Population 


(Col.l) 


Male 
(Col. 2) 


Male 
(Col. 3) 


Female 
(Col. 4) 


Total 
(Col. 5) 


Confined to wheelchair 

Walking with special aids 

Walking with difficulty 

Chronic i npairment of upper 
extremities and shoulders 

Severe auditory impairment 

Severe visual impairment 


43.8 
50.0 
47.5 
68.6 

51.0 
35.9 


195 
2,519 
1,114 
1,777 

953 
173 


250 
2,523 
1,230 

811 

914 
309 


445 
5,042 
2,344 
2,588 

1,867 

482 

J 



65 



This distribution may further be decomposed with respect to other variables. For 
example, 19.5 per thousand population (see Appendix F Table 36) of males 65 years and 
over suffer from impairments of upper extremities and shoulders. Assuming stability of 
this rate of incidence, an estimate for the year 1975 can be obtained by multiplying this 
rate by the projected male population of 9,070 (see Table 11) in the age group 65 and 
above— about 176,000 people. Estimates for other categories of disabilities and 
population types can be similarly obtained when basic data are available. 



environmental problems for elderly 
and handicapped pedestrians 



Backgrouond 

Many handicapped people are greatly inconvenienced or actually prevented from using 
the built environment because of barriers to movement that have been constructed. 
The nature of these barriers within buildings has been quite extensively researched. But 
barriers in the exterior urban environment, on the other hand, are not so well 
understood, and have received comparatively little attention. 

As a result, there is an extending stock of accessible buildings, but nowhere is there an 
accessible town, nor even an accessible district; in fact, there are very few streets that 
are fully accessible, so the routes from accessible building to accessible building may 
well be unusable, or usable with great difficulty. 

The difficulties that face the elderly, as they travel around the town, are even less well 
understood, because the elderly are not thought of as handicapped. While not all of the 
elderly experience handicapping difficulties, nevertheless most do, for the normal 
degenerative processes of advancing age engender physiological and perceptual changes 
that diminish the ability of people to perceive, recognize, and negotiate environmental 
hazards and barriers. 

The purpose of the research described in this study (and the companion volumes) is to 
suggest 'Provisions for Elderly and Handicapped Pedestrians'. Some compilation and 
understanding of the problems is necessary before solutions can be recommended. 

The question is what are these problems (and hazards) facing the elderly and 
handicapped pedestrian? The literature doesn't help us much. It tends to be voluminous 
and repetitious; there are, for instance, several manuals that deal with exterior 
accessibility largely in terms of site planning solutions. But most of the published 

66 



material, and even the standards and codes, have started with the assumption that the 
problems are known. None of the published studies have been directed at identifying 
and classifying the problems in a reasonably comprehensive manner. 

Part 1 of this volume, "Accidents: Causes and Countermeasures" treats the question of 
hazards. Problems are addressed in the study that follows which describes field studies 
conducted in five cities that were directed at generating a typology and a listing of 
mobility problems. 

Scope of the Study 

The scope of the study was limited to 'street related' provisions for elderly and 
handicapped pedestrians. Coincidentally, a study at Syracuse University for the 
Department of Housing and Urban Development was started at the same time and 
programmed to last approximately the same period. That study was directed at 
preparing extensive revisions to the American National Standards Institute, "Specifica- 
tions for making buildings and facilities accessible to and usable by physically 
handicapped people." The specifications deal with both the interior and the exterior 
environment. 

Because the Housing and Urban Development study and this study for the Federal 
Highway Administration were to be carried out more or less simultaneously, it was 
informally agreed that the research at Syracuse University would concentrate 
principally, but not exclusively, on the interior environment, and that the team at 
Georgia Institute of Technology would focus on the exterior urban environment with the 
exception of transportation accessibility which was being addressed by the Urban Mass 
Transit Administration of the Department of Transportation. 

These mutually agreed upon scope limitations inevitably left some areas of overlap. 
Mass transit, for example, cannot be effective if passengers cannot enter and use 
terminals and transit stops. And buildings cannot be used by all if the associated 
parking areas and entrances are not usable. So, as will be apparent from the survey 
topics that are discussed later, the scope has been somewhat widened from being simply 
'street related'. Nevertheless, the project is primarily limited to urban settings rather 
than rural, and access routes rather than parks, recreational areas, and buildings. 

The Field Studies 

Not only is there a very large number of disabilities that handicap people, but also many 
of these disabilities vary in degree. Visual impairment, for example, ranges from near 
sightedness that may prevent people from reading pedestrian signs, to total blindness 
where even the ability to perceive light is absent. Between these extremes lies the 
whole range of visual disabilities, each of which affect, in different ways, the person's 
ability to perceive the pedestrian environment. 

Furthermore, the environment itself is neither constant nor uniform. People with 
disabilities who live in warm climates will have different difficulties to those in cold 
climates. And those who live in towns that have essentially level terrain will have to 

67 



react differently to those in hilly towns. And the environment in poor areas presents 
somewhat different problems to those in wealthier areas. 

For these reasons, and because of the absence of published field studies, it was decided 
to collect data from a representative sample of elderly and handicapped people, and 
from mobility instructors and others who work with them; and to collect the data in five 
cities in the United States that differ substantially in terms of climate, topography, 
socio-economic characteristics and regional location. The cities selected were Atlanta, 
Tampa/St. Petersburg, Chicago, San Francisco, and Seattle. 

Methods Used 

Three very different but complementary techniques were used for gathering the data in 
the field. 

• focussed but unstructured interviews with individuals, 

• panel discussions with groups of people who were elderly and handcapped or who 
work with them, and 

• field observations using mobility tracking . In this method, the observors followed 
individual elderly and handicapped people as they moved around urban areas, and 
then recorded their responses to the environment and to known mobility barriers. 

The focussed interviews were used to obtain information based on the personal mobility 
experiences of elderly and handicapped individuals, and from the experiences of 
mobility instructors and others who work with the problems on a day-to-day basis. The 
panel discussions were used to generate discussion through the interaction of the 
participants, and by this means, to expand the exploration of the topics. The tracking 
studies were used to observe how elderly and handicapped people actually responded to 
the problems of the existing urban environment. A detailed description of each of these 
methodical devices follows. 

The Focussed Interviews 

For the focussed interviews in the five cities, the interview subjects were identified for 
the project team by more than eighty local social and health service agencies, 
community associations, and organizations representing elderly and other disability 
groups. 

All of the organizations that arranged for the interviews were asked not to select 
subjects, but rather to explain the nature of the study to people, and then enable them 
to volunteer. 

In order to improve the representativeness of the sample surveyed, special efforts were 
made by the participating agencies to identify people who do not usually have much 
contact with community-service organizations— either because they are well assimilated 
into society and need little community assistance, or because they are neither 
integrated into society nor in contact with community service groups. 

68 



A tabulation of the various categories of people interviewed in the five cities is shown 
in Table 20; and Tables 21 to 25 in Appendix C list the categories of people interviewed 
in each of the five cities separately. A total of 338 people were interviewed— 194 males 
and 144 females. Ninety-two people were interviewed in Tampa/St. Petersburg; 73 in 
Chicago; 67 in San Francisco; 65 in Seattle; and 41 in Atlanta. 

During the interviews, personal information was elicited from the subjects and recorded 
in a standardized form. The remainder of each interview was used for discussing the 
subject's mobility problems. The interviewer did not attempt to control the 
conversation except to introduce, from time to time, new topics drawn from a check 
list. These topics were largely derived from the literature and were formulated into a 
list, in advance of the survey (and the check list was pre-tested on subjects in Atlanta). 
However, additions were made to the check list as further topical issues were revealed, 
and as the Five-City Survey proceeded. 

The interviews focussed on: 

trip information, 

stamina, 

the effects of weather, 

steps, stairs, ramps, elevators, 

walkway surfaces, 

pedestrian behavior, 

street furniture, 

street illumination, 

street crime, 

signs, 

crossing streets, 

street and sidewalk layout and geometry, 

the law governing pedestrians, 

transportation, 

environmental barriers. 

During the interview, the interviewer made written notes of the subject's responses. 
With the permission of the subjects, the interviews were also tape recorded and these 

69 



recordings were used to elucidate and elaborate on the written notes. The product of 
all these interviews and the panel discussions have been compiled into problem 
statements, and these are presented later. 

The Panel Discussions 

Seventeen panel discussions were held; three in San Francisco; three in Tampa/St. 
Petersburg; three in Atlanta; two in Chicago and six in Seattle. Some of the panels 
consisted of people with various disabilities, and some were composed of people with a 
specific disability— impaired hearing, for example. Most of the panels included both 
people who are handicapped, and people who train, treat, or work with handicapped 
people. 

The panel discussions had the same format as the interviews, focussing on a list of 
topics. However, the composition of the panel membership enabled the team to discuss 
a large number of issues in a comparatively short time. And the interaction between 
the panel members stimulated discussion in some depth on the problems as perceived by 
the group. 

The panels were also productive in bringing forward problems that cause inconvenience 
rather than inaccessibility. Handicapped and elderly people (and also able bodied 
people) have to make many adjustments to the routes that they choose, to allow for 
environmental hazards and barriers. For most able bodied people, a car parked across a 
sidewalk, for example, is an irritating inconvenience which perhaps mandates leaving 
the sidewalk and going into the street in order to walk around the car. For someone in a 
wheelchair, the adjustment may have to be much more extensive, involving crossing the 
road by means of curb ramps and recrossing the road at some place where there are 
more curb ramps. 

The panel discussions were also useful in revealing some factors that an individual might 
fail to mention in an interview because the problem is not thought of as being a 
problem; individuals might forget to mention difficulties and hazards which they accept 
as a normal part of using the environment. For example, a visually impaired person 
might fail to mention the hazards of walking into a low overhanging street sign, simply 
because low street signs are a common occurrence. 

The comments made at the panel discussions were recorded on tape, with the permission 
of the participants, and later translated into the problem statements that are presented 
later in this report. 

Mobility Tracking Studies 

The interviews and panel discussions provided a long list of problems experienced by the 
elderly and handicapped pedestrians. But from the outset of the study, it was decided 
that some observations of the target group actually using the urban environment would 
be necessary for several reasons. Firstly, it seemed extremely probable that 
observations would reveal many examples of coping and problem avoidance behavior 
that might not surface in discussion. Secondly, the observations would record actual 

70 



behavior rather than described behavior, and would therefore serve to verify and 
elucidate some of the stated problems. Thirdly, the observations would be unobtrusive, 
and therefore, would not affect the responses of the subjects in the way that interviews 
and panel discussions might; the observed subjects would respond to the environment in 
their usual way, while in discussion the subjects, for example, might feel a duty to 
discuss what they understood to be the problems of other handicapped people, rather 
than their own problems (and in practice, this was found to be the case quite often). 

In each of the five cities, locations for tracking studies were selected largely on the 
basis of their probable frequency of use by elderly and handicapped people; for example, 
streets adjoining housing for the elderly, rehabilitation units, health facilities, sheltered 
work shops, downtown shopping and business areas, recreation areas, etc. 

The subjects were selected for observation solely based on their characteristics 
matching the target groups discussed earlier. After identifying a subject, the observer 
would unobtrusively follow at a discrete distance, noting the way the subject used the 
environment, and particularly, the ways in which the behavior differed from the rest of 
the population. 

For example, tracking report #194 is of an elderly white male, 65-70 years old, who uses 
a cane. From the tracking notes we find that his movement is 'very unstable and very 
slow', 'had a problem in crossing the street within the time allotted by the traffic light', 
'at the curb he used a lamp post to stabilize himself while stepping down into the 
street'. 

In about ten percent of the observations, the observor would catch up with the subject 
and discuss the reasons for the behavior—after identifying himself and briefly describing 
the project. The purpose of these short interviews was to elucidate puzzling behaviors, 
and to confirm or refute the observers conclusions. 

The observer recorded his notes on a form which included space for standardized 
information on the location, weather, time; and the age, sex, race and handicap of the 
subject. After completing the observations for a subject, usually within five to ten 
minutes, the observer would select the next elderly or handicapped person who came 
into view, and start the process again. The observer did not follow subjects into 
buildings or on to transportation, nor for a distance greater than about three city 
blocks. 

A total of 619 tracking observations were made: 109 in Tampa/St. Petersburg; 136 in 
Chicago; 154 in San Francisco; 160 in Seattle; and 60 in Atlanta. Tables 40 to 45 in 
Appendix J list the categories of people observed in total and for each of the five cities 
separately. And the conclusions from the tracking study have been included in the list 
of problem statements that follow. 

The Problem Statements 

The problem statements that follow are the cumulative result of the focussed 
interviews, the panel discussions and the tracking study. The material has, of course, 

71 



been categorized, and the wording of the problems as stated has been edited for clarity. 
Some of the statements differ from each other only slightly, but these differences are 
considered to be significant enough to warrant retention. For example: 

• I cannot descend ramps. 

• I cannot descend steep ramps. 

The statements do not represent any sort of consensus. In fact, a problem may have 
been articulated by only one of the people interviewed. A discussion on the general 
importance of problems is taken up later. 

trip information 

1. I WOULD GO OUT OR MAKE MORE TRIPS; 

• If public transportation was made accessible. 

• If there was more public transportation. 

• If there was cheaper transportation. 

• If environmental barriers were removed. 

• If walkways were repaired and maintained. 

• If walkways were easier to travel over. 

• If walkways were kept clear of snow and ice. 

• If I didn't have to travel so far to shops, etc. 

• If I had a suitable vehicle. 

• If I had an electric wheelchair. 

• If I had a more dependable wheelchair. 

• If someone would assist me during trip. 

• If there were more accessible parking places I could use. 

• If the crime problem was eliminated. 

• But I am afraid of crime at night. 

• But I am afraid of being mugged if I stopped to rest. 



72 



• If benches were placed where I would not be mugged. 

• If I had mobility training in how to get around. 

• But I need a guidebook to accessible facilities. 

• If public recreation areas were more accessible. 

• If there were more places for me to rest. 

2. I PLAN MY ROUTE IN ADVANCE : 

• To keep it as short as possible. 

• To conserve my energy. 

• To avoid hazardous situations. 

• To avoid obstacles. 

• To avoid busy pedestrian walkways, 

• To avoid heavily trafficked streets. 

• To avoid traffic lights that change quickly and don't give me enough time to cross 
the road. 

• To avoid getting lost. 

• To avoid high crime areas. 

3. GENERAL TRIP STATEMENTS ; 

• In many places there are no sidewalks or walkways provided and I cannot travel in 
the road. 

• Public interferes with my guide dog. 

• Public is ignorant of guide dog laws. 

• Public is often unwilling to help me when I am in difficulty. 

• Public often tries to help me when I do not require it. 

• Public doesn't believe a person is deaf if he can speak. 

• Public sometimes thinks that a handicapped person is begging. 

• Some handicapped people are mistaken for drunks. 

73 



• Some people think that the handicapped are also mentally retarded. 

• Drivers can't recognize that I am disabled. 

• Pedestrians don't recognize that I am disabled. 

• Poorly made or improperly made prosthesis increases my mobility problems. 

• Some voting stations are not accessible, and I cannot vote without assistance. 

• There are too few pedestrian walkways. 

hills, ramps, stairs, handrails, guardrails 

1. HILLS : 

• Hills are difficult for me to negotiate. 

• Hills are difficult for me to negotiate when wet. 

• I cannot descend hills. 

• I cannot descend steep hills. 

• Descending hills is difficult for me. 

• I cannot ascend hills. 

• I cannot ascend steep hills. 

• Ascending hills is difficult for me. 

• I cannot negotiate hills. 

• I have balance problems on hills. 

• I need handrails on hills. 

2. RAMPS ; 

• Sidewalks with a noticeable cross slope make movement very difficult for me. 

• Sidewalks with a noticeable cross slope induce many severely visually handicapped 
people to veer sideways. 

• I cannot descend steep ramps. 

• I cannot descend ramps. 

74 



• Ramps are difficult for me. 

• I am afraid of slipping on ramps. 

• I cannot negotiate ramps. 

• I cannot ascend long ramps. 

• I prefer steps to ramps for descent. 

• I prefer steps to ramps for ascent. 

• I prefer ramps to steps for descent. 

• I prefer ramps to steps for ascent. 

• Some ramps with an abrupt transition to the connecting walkways cause my 
footrest to hit the ground. 

• Ramps without handrails are difficult for me to negotiate. 

• I need handrails on ramps. 

• Ramps are often too narrow for me. 

• I am afraid of losing my balance on ramps. 
3. STEPS, STAIRS, FIRE ESCAPES ; 

• I cannot manage any step without help. 

• I can only manage 1 or 2 steps without help. 

• I can manage stairs with difficulty. 

• I have difficulty descending stairs. 

• I have difficulty ascending stairs. 

• High risers are very difficult for me. 

• Mobile home steps are often too high for me without help. 

• Small steps (up to 2" high) are difficult for me. 

• Small steps (up to 2" high) are impossible for me without help. 

• A step at the bottom of a ramp that is as little as 1" may cause my chair to 
overturn if I 'take a run' at it. 

75 



handrails and guardrails 

1. HANDRAILS t 

• I always use handrails ascending stairs. 

• I always use handrails descending stairs. 

• I need handrails for ascent and descent on stairs. 

• I need handrails for descent on ramps. 

• I need handrails for ascent on ramps. 

• Handrails are often inadequate for me to grasp comfortably. 

• Handrails often don't feel secure to me. 

• Handrails are often too high. 

• Handrails are often too low. 

• Handrails are sometimes on the wrong side, and unless there is a center handrail, 
two-way traffic makes it difficult for me to use the one I need. 

• Handrails don't extend far enough past top and bottom of stair for me to use them. 

• Handrails are often not continuous. 

• Handrails are often too slippery to hold. 

• Handrails of metal become too hot in summer or too cold in winter for outdoor 
use. 

2. GUARDRAILS : 

• There is often no guardrail protecting grade changes. 

• People with limited vision may trip or fall at street repair sites which don't have 
adequate protective barriers. 

• Some types of protective barriers and particularly those with chains are hazardous 
because people with low vision and those visually impaired people who use canes 
may fail to detect them. 



76 



stamina 

1. WHEN WALKING OR WHEELING UNDER IDEAL CONDITIONS, I MUST STOP 
AND REST : 

• After traveling for less than one (1) minute. 

• After traveling between one (1) and five (5) minutes. 

• After traveling five (5) to ten (10) minutes. 

2. WHEN TIRED, I HAVE TO REST APPROXIMATELY : 

• Less than two (2) minutes. 

• Two (2) to five (5) minutes. 

• More than five (5) minutes, but less than fifteen (15). 

• Fifteen (15) minutes or more. 

3. WHEN TIRED, I HAVE TO : 

• Rest where the benches are. 

• Often find curbs or steps to sit on. 

• Go to a cafe to rest. 

• Return to the car to rest. 

• Frequently rest against a pole or wall. 

• Stand and rest. 

• Rest wherever it is possible. 

• Find a place to get warm (or cool). 

4. RESTING PLACES : 

• There are too few seats on which I can rest. 

• There is usually no place for me to sit under cover when it is raining. 

• Need weather protection for benches. 

• Need benches at bus stops. 

77 



• Benches are usually too low for me. N 

• Benches are usually too high for me. 

• There are often no arm rests to help me get up from, or down to, benches. 

• Benches are often uncomfortable for me to sit on. 

• Benches often don't dry quickly enough after rain. 

• There are too few resting places for me. 

• There are too few resting places out of the traffic stream for wheelchairs. 

weather 

1. RAIN ; 

• Damp conditions decrease my agility. 

• I am afraid of slipping on wet sidewalks. 

• It is difficult for me to hear traffic sounds in rain. 

• My wheelchair brakes work poorly in wet weather. 

• My wheels (and hands) get muddy in wet weather. 

• The drive on my electric wheelchair tends to slip in wet weather. 

2. WIND ; 

• When I travel against a wind it is very tiring. 

• I have difficulty in maintaining my balance in wind. 

• Wind decreases my ability to hear traffic. 

• Wind blows my wheelchair off course. 

• Wind-blown dust affects my vision. 

• I cannot wipe dust from my eyes. 

3. SNOW AND ICE ; 

• I can never go out in snow and ice. 

• Snow reduces sound cues. 

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• Snow and ice cover location cues. 

• Snow and ice are frequently not cleared from the sidewalk. 

• Crossings are frequently not cleared of snow and ice. 

• Snow is not cleared from minor streets. 

• Snow plows often dump snow on sidewalks. 

• I cannot climb over snow pushed into the gutter when I wish to catch the bus. 

4. COLD CONDITIONS ; 

• Cold conditions decrease my agility. 

5. HOT CONDITIONS ; 

• Hot conditions decrease my agility. 

• High humidity decreases my agility. 

surfaces 

INTERIOR SURFACES— GENERAL 
1. WHEN WALKING/WHEELING AROUND, I OFTEN FIND THAT ; 

• Wood flooring is often too slippery. 

• Terrazo flooring is often too slippery. 

• Plastic tile floors are often too slippery. 

• Polished marble is often too slippery. 

• Wet, smooth surfaces are usually too slippery. 

• Entrances to buildings are often wet and slippery. 

• Throw rugs are likely to slide. 

• Thick carpeting or padded carpeting is difficult to move across. 



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EXTERIOR SURFACES— GENERAL 

1. WHEN WALKING/WHEELING AROUND, I OFTEN FIND THAT : 

• Where sidewalks pass filling stations and parking lots, paved with the same 
material as the sidewalk, I may wander off the walkway unintentionally because I 
cannot see. 

• Surfaces with many paving joints cause me discomfort because they cause jolting. 

• Surfaces which are uneven at the joints are difficult for me to cross. 

• I am concerned that paving joints may cause me to trip. 

• Some paving joints are slippery when wet or icy. 

• Weeds in paving joints may cause me to slip and trip. 

• Sand, gravel or loose material is difficult for me to negotiate. 

• Sand, gravel or loose material is impossible for me to negotiate. 

• Muddy surfaces are impossible for me to negotiate. 

• Muddy surfaces are difficult for me to negotiate. 

• Brick surfaces are impossible for me to negotiate. 

• Brick surfaces are difficult for me to negotiate. 

• Uneven and irregular surfaces are impossible for me to negotiate. 

• Uneven and irregular surfaces are difficult for me to negotiate. 

• Lawns are difficult for me to negotiate. 

• Lawns are impossible for me to negotiate. 

• I rely on sound cues generated by traffic moving over surfaces. 

2. SIDEWALKS : 

• Sidewalks and walkways which have a noticeable slope to one side make it 
difficult for me to travel in a straight line. 

• Badly maintained sidewalks often prevent me from using them. 

• I must frequently avoid dog excreta on sidewalks. 

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I must frequently avoid garbage and litter on sidewalks. 

I cannot see dog excreta, litter, or garbage on sidewalks. 

Cars parked on the sidewalk are a frequent barrier. 

I am afraid of bicycles ridden on pedestrian paths. 

I am frequently forced to travel on roads because of sidewalk barriers. 

Sometimes I move off the sidewalk into the road by mistake, if there are no 
obvious separations between the sidewalk and the road. 

If there are no sidewalks, it is difficult for me to get around. 

If there are no sidewalks, it is impossible for me to get around. 

ROADS ; 

I have to be careful not to slip on gutters at the side of roads. 

I am frightened of slipping on areas of roads on which oil from vehicles has leaked. 

Large paved areas of service stations and the entrances to parking lots are 
confusing or make it difficult for visually impaired people to find their way. 

ACCESS/SERVICE COVERS, ETC. ; 

Some types of grating impede my movement. 

Manhole covers will impede my movement. 

Crutches, canes and the wheels of wheelchairs can easily snag in certain types of 
gratings, and this is hazardous. 

Manholes and other access covers tend to be slippery when wet or icy. 

REPAIR SITES ; 

Repair and building sites not kept clear of debris are a frequent barrier. 

I am afraid of having a fall at street repair sites because they often don't provide 
warning barriers that I can detect before I walk into them. 

I am afraid of falling into unprotected ditches and holes. 

' Sidewalk repair sites are often a barrier for me. 



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6. TRAIN TRACKS ; 

• It is impossible for me to cross most train and tram tracks. 

• It is difficult for me to cross train and tram tracks. 

• Many railroad crossings have warnings which I cannot perceive. 

congestion 

1. GENERAL : 

• I am afraid of moving in crowds. 

• I am afraid of being bumped. 

• I am afraid of crowded stairs. 

• I avoid going out in crowds. 

• I am concerned that I may bump into people. 

• It is very difficult for me to maneuver in crowds. 

• Crowds make me lose my sense of direction. 

• Some sidewalks are too narrow for me to travel on without difficulty. 

• I will usually stop to allow crowds to disperse before moving along sidewalks. 

• For safety, I prefer to move with a group of people rather than on my own. 

2. ON WALKWAYS I TEND TO : 

• Travel faster than most people. 

• Travel slower than most people. 

• Travel about the same speed as most other people. 

mailboxes, parking meters, lamp posts, etc. 

1. GENERAL 

• I am afraid of bumping into low overhanging projections— branches, signs, awnings, 
etc., that I cannot see. 

• I am afraid of bumping into drinking fountains, parking meters, etc. 

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• I am afraid of bumping into, or tripping over, low objects. 

• I may not be able to detect all low or suspended objects like guardrails and chains 
before bumping into them. 

• Lamp posts, parking meters, etc., at curb edges and corners, usually obstruct my 
movement. 

• Moveable street furniture (newspaper dispensers, portable signs, etc.) often 
obstructs my movement. 

• I often use lamp posts, mailboxes, etc., to tell me where I am. 

• I am concerned that mailboxes, lamp posts, etc., will prevent drivers from seeing 
me when I am about to cross the road. 

• I often use mailboxes, lamp posts, etc., to help me climb onto the curb. 

• I often use mailboxes, lamp posts, etc., to help me down the curb. 

lighting, signs, perception 

1. DAYLIGHT ; 

• Sunlight reflected off light-colored surfaces makes it difficult for me to see 
where I am going. 

• Bright sunlight and shadows make it difficult for me to see the walkway. 

• It is difficult for me to see traffic lights in bright sunlight. 

2. NIGHT LIGHTING— ARTIFICIAL ; 

• I cannot use walkways where the surface is poorly illuminated. 

• It is difficult to use walkways where the surface is poorly illuminated. 

• Poorly lighted steps and stairs are particularly hazardous for me. 

• I am concerned about crime in poorly lighted areas. 

• I am afraid that drivers won't see me at night. 

• Illuminated advertising signs often make it difficult to see traffic signals. 

• I am concerned that drivers will not notice me. 

• I am concerned that drivers won't notice the dog that accompanies me. 

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3. STREET NAMES AND PEDESTRIAN TRAFFIC SIGNS AND SIGNALS : 

• I often cannot read street signs and signals because they are too small and too 
high. 

• Because I have limited head movement, I may not see signs that do not face my 
direction of travel. 

• I find that I cannot read street signs at night because they are poorly illuminated. 
$ Street signs are frequently obscured by other street equipment. 

• I am concerned that confusing signs distract the driver from seeing pedestrians. 

• I cannot read written signs. 

• Information in transit terminals and other places is usually given by visual means 
or public address systems, but not both. So some people will not receive the 

messages. 

• I cannot understand signs that use symbols instead of words. 

• I cannot understand complicated instructions on signs. 

• I cannot see signs and signals. 

• I have difficulty in seeing road markings, particularly in wet weather. 

• I am afraid to cross roads where there are no road markings. 

• I am concerned that often vehicular traffic warnings are located too close to the 
hazard for the driver to have adequate time to react. 

traffic lights, crossing roads, curb ramps 

1. TRAFFIC LIGHTS ; 

• In some places it is difficult to know Which traffic light I must respond to. 
$ I sometimes find that traffic lights are placed too high for me to see. 

• Parked vehicles sometimes obscure traffic signals. 

• Advertising signs and other lights sometimes make it difficult for me to see the 
traffic light. 

• Traffic lights often don't allow me sufficient time to cross the road. 

• Pedestrian crossings which are not controlled by lights are difficult for me to use. 

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• I cannot operate the buttons which control the traffic lights at pedestrian 
crossings. 

• It is difficult for me to operate the buttons which control traffic lights at 
pedestrian crossings. 

• I cannot see the traffic lights. 

• I do not understand the traffic lights. 

• I do not understand the meaning of the continual flashing 'don't walk' sign. 

• I cannot see 'walk/don't walk' signs across the street. 

• Right turn on red traffic light makes crossing the street more difficult for me. 

• I am concerned that traffic turning on green lights will not give me the right of 
way. 

• Special signals and green arrows that permit traffic to turn make me apprehensive 
about crossing the road. 

2. CROSSING ROADS ; 

• I cannot cross road surfaces which are in bad condition at crossings. 

• I find it difficult to cross road surfaces which are in bad condition at crossings. 

• I find it difficult to cross roads that are at all wet, slippery, or oily. 

• I have to be careful to avoid manhole covers and gratings in crossings. 

• On busy sidewalks there is seldom enough space for people to wait for the 'walk' 
signal. 

• Frequently, parked cars obstruct crossings. 

• At crosswalks my view of oncoming traffic is frequently blocked by parked cars. 

• Vehicles that stop in the pedestrian crossing make it difficult for me to cross. 

• Some roads have too much slope from the center of the road to the gutter and this 
makes crossing the road much harder for me. 

• Overpasses and underpasses are seldom accessible to people in wheelchairs, and 
other handicapped people. 

• I am afraid of slipping on painted road markings. 

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• Because of poor illumination, I am afraid that drivers will not see me at night. 

• I am concerned that I may unknowingly move out of the crosswalk into the traffic 
stream. 

• It is difficult for me to maintain a correct sense of direction when crossing streets 
that meet at an angle which is not a right angle. 

• It is difficult for visually impaired people particularly, to cross streets where 
there are 4-way stop signs. 

• It is frequently difficult for me to cross the road because I cannot locate the 
crosswalks. 

• It is often difficult for me to locate precisely the junction between the crosswalk 
and the sidewalk. 

• I am very apprehensive about crossing very wide, busy streets. 

• I am concerned that when I am caught in the crosswalk when the lights change, 
the motorist's view of me from the middle lanes may be obscured by large vehicles 
in the outer lane. 

• I cannot cross busy streets even at crosswalks. 

• I am apprehensive about crossing busy streets even at crosswalks. 

• I am concerned that there is insufficient warning to motorists of crosswalks. 

• I am concerned that motorists will not see me entering the crosswalk because 
their view is obscured by trees, poles, planters, parked cars, street furniture, etc. 

• I am concerned that, because of my small stature in a wheelchair, drivers will not 
see me. 

• Two-way streets are more difficult to cross than one-way streets. 

• It is difficult for me to cross roads if there is traffic movement in any direction 
during the pedestrian walk cycle. 

• It is difficult for me to cross the road if the traffic noises are obscured by loud 
construction or other noises. 

• I am unable to tell when traffic lights change. 

• I am concerned when I cross the street that I will not hear the approach of 
bicycles and other relatively silent vehicles. 



86 



• I am concerned that when I use crossings near the brow of hills, oncoming traffic 
will not see me. 

• Where right turns on red are permitted, and where the driver's view to the left is 
blocked by hedges, trees, buildings, etc., vehicles will edge forward into the 
crosswalk. This is inconvenient and hazardous. 

3. CROSSING BEHAVIOR ; 

• I avoid crossing the road with the crowd whenever possible. 

• I try to cross the road with the crowd whenever possible. 

• When I must cross the road and there is no crosswalk, I am concerned that I may 
misjudge the speed of the traffic. 

4. JAYWALKING 

I FREQUENTLY JAYWALK : 

• To use driveway entrances because there are no curb ramps at the crosswalk. 

• Because there are no marked pedestrian crossings. 

• To shorten my route. 

• Because I am in a hurry. 

• To conserve my energy. 

• To avoid wind or sun. 

• Out of crosswalk to use the curb ramps. 

• Because the sidewalk is crowded. 

• Because the crosswalk is crowded. 

5. TRAFFIC ISLANDS AND HAVENS : 

• It is impossible for me to cross wide busy streets. 

• It is difficult for me to cross wide busy streets. 

• I cannot cross most traffic islands because of the curbs. 

• I cannot use most traffic islands because they are too small. 

• I am frightened of using small traffic islands in busy streets. 

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• Many traffic islands are too narrow for wheelchair use. 

• I cannot use traffic islands that don't provide something to rest on or lean against. 

6. CURBS ; 

• High curbs are impossible for me to negotiate without help. 

• High curbs are difficult for me to negotiate. 

• I can't get down curbs without help. 

• I can't get up curbs without help. 

• I am concerned that I may not see very low curbs and fall. 

• All curbs are difficult for me to negotiate. 

• I cannot negotiate curbs without something to pull or lean on. 

• I cannot negotiate curbs without assistance. 

• I am afraid of having an accident caused by a curb edge that is in a broken 
condition. 

• When the edge of the sidewalk is carried around the corner with a large radius, I 
find it difficult, because I cannot see, to locate myself properly when preparing to 
cross the road. 

7. CURB RAMPS : 

• I cannot ascend any curb ramps. 

• I cannot descend any curb ramps. 

• I cannot ascend curb ramps without handrails. 

• I cannot descend curb ramps without handrails. 

• The side flares of curb ramps are usually much too steep for my wheelchair to 
cross without losing my balance. 

• Curb ramps are difficult to ascend. 

• Curb ramps are difficult to descend. 

• Quite often there is not enough level space at the top of a curb ramp for me to 
slow down my wheelchair and to stop. 

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• I won't use curb ramps when they are slick or wet. 

• Curb ramps often are too narrow for me. 

• I cannot manage steep curb ramps. 

• I find that steep curb ramps are difficult to negotiate. 

• A step of even an inch at the bottom of a curb ramp may cause my wheelchair to 
overturn if I 'take a run' at the ramp. 

• I am afraid of curb ramps that direct me outside of the street crossing into the 
traffic. 

• I am afraid of using curb ramps because some of them do not direct me into the 
crosswalk. 

• I prefer curbs to curb ramps for descent. 

• I am concerned that I may not detect the curb ramp and wander into the road by 
mistake. 

• I am concerned that I may not notice the curb ramp and fall. 

• At intersections, curb ramps are often located so that I must travel across them if 
I wish to go around the corner. This is difficult and sometimes hazardous for me 
to do, because the ramp flares are so steep. 

• Some curb ramps are very difficult for me to use because I must make an abrupt 
turn at the top or bottom in order to continue to move in the desired direction. 

• Very often there is a curb ramp on one side of the street only. 

• Unlike curbs, curb ramps do not provide visually impaired people with an edge on 
which to wait for the traffic lights to change. 

• Frequently, curb ramps are located by a gutter, or where storm water flows when 
it rains, and this leaves the bottom of the ramp slippery. 

• In some locations, curb ramps serving two crosswalks at right angles to each other 
are placed close together. This creates an area of undulating ground that is 
uncomfortable and hazardous. 

• Where curb ramps project into the street, I am concerned that vehicles may ride 
over the ramp where I am waiting. 

• Some ramp surfaces are finished with gravel (for detection by the visually 
impaired). If this gravel becomes loose, the ramp becomes slippery. 

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• Some ramp surfaces are finished with a rough texture that is difficult to sweep 
clean, and loose materials may cause slips and falls. 

• Grooves and patterns cast into curb ramps tend to collect water, ice and other 
materials, and this makes the ramps slippery. 

• Some curb ramps are painted. The paint may clog the surface and make the ramp 
more slippery. 

• Some curb ramps are located next to planters, poles, etc., which obstruct my view 
of traffic, and hide me from the view of vehicles. 

8. EDUCATION, LEGALITIES AND PEDESTRIAN RIGHTS ; 

• The law relating to pedestrians seems to vary from state to state. 

• I have had insufficient training in road crossing. 

• I have had no training in road crossing. 

• I have to be very cautious when I cross the road because vehicles often exceed the 
speed limit. 

• If traffic laws were more rigidly enforced, it would be easier for me to cross 
roads. 

• I cannot move around the city because traffic laws that protect my rights are not 
enforced. 

• I am concerned that motorists may not know the laws relating to white canes and 
guide dogs. 

• It is difficult for me to cross roads at night or in bad weather because vehicles do 
not reduce speed to allow for these adverse conditions. 

barriers 

1. DOORS ; 

• Some entrance doors are impossible for me to open because of springs or the force 
of the wind, etc. 

• Some entrance doors are difficult for me to open because of springs or wind, etc. 

• I have difficulty opening all manually operated doors. 

• Revolving doors are difficult for me to use. 

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Revolving doors are impossible for me to use. 

Doors often are not wide enough for me to go through. 

Entrances I can use are frequently through service yards and other out-of-the-way 
places. 

I am apprehensive of bumping into glass doors and partitions that I may not see. 

I often find it difficult to find the door when the door is of glass and positioned in 
a glass partition. 

I often use my wheelchair to push open doors. 

I cannot use some doors because there is insufficient room for the open door and 
the wheelchair at the same time. 

I often find the space between the end of a flight of steps and a door is inadequate 
for me. 

Entrance doors which are served by walkways with steep grades are very difficult 
for me and other wheelchair users to open. 

Before I go through doors which have closers, I have to prop open the door. 

I often find that the lobby between two doors is too small for me to negotiate. 

It is difficult for me to use turnstiles. 

It is impossible for me to use turnstiles. 

DOOR KNOBS, ETC. ; 

I have difficulty using round door knobs. 

I have difficulty using lever type door knobs. 

I find that most handles are too small for arm operation. 

Where doors have no knobs it is difficult to know where to pull or push on them. 

It is impossible for me to open fire doors which have panic bars. 

It is difficult for me to open fire doors which have panic bars. 

3. THRESHOLDS ; 

• I cannot negotiate raised thresholds. 

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• I have difficulty negotiating raised thresholds. 

4. ESCALATORS ; 
I cannot use escalators. 
I am frightened to use escalators. 
It is difficult for me to get on and off escalators. 
It is difficult for me to see the edges of escalator treads. 

5. ELEVATORS : 
Elevator doors usually close too quickly for me. 
Closing elevator doors often bump against me before they open again. 
Some elevator doors are too narrow for me to negotiate. 
Some elevator cabs are too small for me to turn my wheelchair. 
I often cannot find elevator buttons. 
I often cannot reach elevator buttons. 
I cannot operate recessed buttons. 

Ash trays sometimes restrict my access to elevator buttons. 

When using elevators in tall buildings with which I am not familiar, it is difficult 
for me to find the right button. 

When the elevator arrives, for which I have been waiting, I cannot tell whether it 
is going up or down. 

The crack between the elevator and floor is often too wide. 

I often find that the elevator cab does not stop level with the floor. 

I am afraid of being trapped in an elevator. 

I am sometimes afraid of being trapped in the elevator because it moves so 
smoothly I cannot tell that it is moving. 

I am afraid of crime in elevators. 



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6. TELEPHONES ; 

I cannot get into phone booths. 

I can only get into phone booths with difficulty. 

I cannot put money into the slot. 

I can put money into the slot with difficulty. 

Because I am slow in putting in money or dialing, I am often disconnected, and 
cannot complete my call. 

I cannot hold telephones. 

I can hold telephones with difficulty. 

Pay phones are often too high for me. 

Telephone cords often are too short. 

The counter prevents me from reaching the pay telephone. 

It is too tiring for me to stand when telephoning. 

Outside noises make it difficult for me to hear on pay telephones. 

Phone booths are often too dark for me to read the phone book. 

Phone dials are impossible for me to use. 

Phone dials are difficult for me to use. 

Touch phones are confusing to me. 

Touch phones are difficult for me. 

Touch phones are impossible for me to use. 

Because of my physical condition, I cannot locate public telephones. 
© I cannot use a telephone unless it has special equipment. 

7. DRINKING FOUNTAINS ; 

• Many drinking fountains are too high for me. 

• Many drinking fountains are too low for me. 

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• Some people cannot lean over drinking fountains and must use cups. 

• I cannot use hand-operated water controls. 

• I can use hand-operated controls with difficulty. 

• I cannot use foot-operated water controls. 

• I can use foot-operated water controls with difficulty. 

• Because of my disability, I cannot locate drinking fountains. 

8. REST ROOMS : 

• I find that most rest rooms are inaccessible to me. 

9. OTHER : 

• The support wires for lighting poles, etc., are a hazard to many visually impaired 
people who cannot detect them. 

© Mailboxes are difficult for me to use. 

• Because of my disability I cannot locate mailboxes. 

• I bump into protective barriers because they are too high to be detected by my 
cane. 

• Trash receptacles are difficult for me to use. 

• It is difficult for me to make sharp turns. 

® Counters in shops, etc., are often too high for me. 

• Street furniture of ten blocks the passage of people in wheelchairs. 

• Corridors and aisles are often not wide enough for me. 

• Because I have no vision, I find it difficult to find my way around many buildings. 
G I often find that I cannot reach or operate fire alarm buttons. 

• I cannot hear fire alarm or emergency vehicles. 

• Some fire hydrants (and other street furniture) have sharp projections which are 
hazardous, particularly for people with impaired vision. 

• Low, overhanging signs, awnings, and tree branches are hazardous, particularly for 
those with impaired vision. 

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• I cannot use trash cans that require you to use two hands. 

• Many vending machines are too high or too low for use by handicapped people. 

• Many vending machines have controls and coin slots that cannot be used by people 
who have limited manual dexterity. 

public transportation 

1. BUSES : 

• I don't get enough time to board buses. 

• I don't get enough time to sit after paying my fare before the bus moves off. 

• I don't get enough time to leave buses. 

• The bus often doesn't stop close to sidewalk, making the first step up or down too 
great for me. 

• On buses, there is not enough support to aid my access or egress. 

• I cannot stand on buses. 

• It is difficult for me to have the exact change ready. 

• I have to temporarily set my prosthesis aside in order to climb aboard buses. 

• If the bus does not stop with the door aligned with the bus stop, it is difficult for 
me to locate the door. 

• Because of my physical condition, I find it difficult to travel from the bus stop to 
the shopping center across the shopping center car park. 

2. TRAINS/SUBWAYS : 

• I cannot cross the gap between the vehicle and platform. 

• I can cross the gap between the vehicle and the platform with difficulty. 

• The long flights of stairs up to elevated railway platforms are difficult for me to 
climb. 

• The long flights of stairs up to elevated railway platforms are impossible for me 
to climb. 

3. AIRPLANES : 

• It is difficult for me to find my way around airports without assistance. 

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• I frequently cannot understand airport signs. 

• I cannot see airport signs. 

• It is frequently too far for me to walk without assistance. 

• lam sometimes denied passage by airlines. 

• Aisles on airplanes are too narrow for me. 

• Seats are difficult for me to get into, and out of, on airplanes. 

• Airplane toilets are inaccessible to me. 

4. TAXIS ; 

• Drivers sometimes refuse to accept me as a passenger. 

• Drivers sometimes refuse to help me get into, and out of, the vehicle. 

• Drivers usually don't know how to help me get into, and out of, the vehicle. 

• Some taxi doors are too small for me. 

• Some taxi seats are too high for me. 

• Some taxi seats are too difficult for me to get into. 

5. PUBLIC TRANSPORTATION— COMMON PROBLEMS ; 

• Because of my physical condition, I cannot walk far to public transportation or 
shops. 

• I cannot climb up or down the steps of vehicles. 

• It is difficult for me to climb up or down the steps of vehicles. 

• I cannot read route indicators. 

• I often do not know when I have reached my destination without asking. 

• I cannot understand messages on the public address system. 

• It is difficult for me to put coins into coin slots. 

• It is difficult for me to put money into change machines. 

• It is impossible for me to put money into coin slots. 

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• It is impossible for me to put money into change machines. 

• I am afraid of being knocked off balance by vehicle doors which close too quickly 
for me. 

^ I am afraid of losing my balance on moving vehicles. 

% I need poles, etc., to hold onto on moving vehicles. 

• Straps and poles are difficult for me to hold. 

• I need a wider seating space than is usual. 

• I am afraid of crime while traveling in public transportation. 

automobiles 

1. CARS ; 

• I cannot open car doors on hills. They are too heavy. 

2. CAR PARKS ; 

• Parking spaces are often too narrow. 

• Parking spaces reserved for the handicapped are often used by the able bodied. 

• It is hazardous for people in wheelchairs to have to travel behind a row of cars in 
parking lots. The drivers of cars backing out may not notice them. 

• Parking spaces are often too far away from my destination. 

• New pedestrian malls often exclude the handicapped because they have to park 
too far away from their destination. 

• There are often barriers between parking places and destinations. 

• It is difficult for me to find my way in parking lots without assistance. 

• It is difficult for me to use car parking spaces unless they are level. 

• Many parking garages have ceiling heights that are too low for the specially 
adapted van that I use. 

• It is impossible for me to find my way in parking lots without assistance. 

• I am concerned about crime in car parks. 

• I cannot get tickets from parking ticket dispensers. 

97 



• It is difficult for me to get tickets from ticket dispensers. 

3. HIGHWAYS : 

• Rest areas on highways are often not accessible to me. 

• Highway shoulders are often not wide enough to permit me to leave my vehicle. 

4. GENERAL/CAR : 

• Because of my physical condition, I need special parking privileges. 

Establishing Research Priorities 

Approximately 750 problem statements have been listed and these are subdivided into 
14 categories and 55 subcategories. This list of statements is not exhaustive but it 
probably covers the most obvious of the problems experienced by elderly and 
handicapped pedestrians. 

Not all of the statements fall comfortably within the scope of the present research. 
However, they have been retained on the list because they indicate problems which 
seem to require attention. Into this category fall many of the statements that reflect 
perceptions of societal and attitudinal responses, such as: 

• public doesn't believe a person is deaf if he can speak. 

• some handicapped people are mistaken for drunks. 

Obviously, the survey provided very limited evidence that these statements are true, 
and no evidence on the universality of these attitudes. Nevertheless, they can be 
considered as plausible hypotheses for future evaluation, and their inclusion is necessary 
for an understanding of the overall problem. 

The statements that fall within the scope of the study have been treated in one of 
several ways. If the stated problem seems to be self evident with obvious and well 
known solutions, then the problem and recommended solutions have been presented in 
the "Implementation Package". As an example of problems of this type we have: 

snow and ice are frequently not cleared from the sidewalk. 

No further research is needed to test the general validity of the comment, nor to 
establish that people in wheelchairs, and people on crutches particularly, are adversely 
affected by this condition. 

The remaining statements can be divided into two types— those where the validity of the 
statement remains in doubt, and those where the statement is probably valid but the 
solutions are either unknown or are suspect. In both cases, further research is needed. 
However, the number of problems stated in this group is far more than could be treated 

98 



within the financial and time constraints of the contract. It was therefore necessary to 
reduce the number to a manageable quantity. 

Several methods of selecting problems for further work were considered. One method 
that was rejected would have involved the development of a highly structured survey 
based on the statements. The survey would thus have provided a measure of the 
popularity of each statement included. This method was rejected, firstly, because of 
the time and expense constraints, but also because the results would have favored 
statements that affect the majority rather than the minorities. A problem that is 
unique to the visually impaired, say, would be unlikely to be popular with the whole 
target population because the visually impaired constitute a relatively small part of the 
population. 

Finally, it was decided to make use of the opinion of a panel of experts to make a final 
selection of the problems to be dealt with further. The panel was chosen to include 
people who would represent each of the target subgroups. The prime responsibility of 
each panel member therefore, was to speak for the group he or she represented. 

Each representative selected suffered from the same disability as the members of his or 
her constituency, and was also an expert in mobility, so the consumers were well 
represented. It was hoped that by this procedure a consensus could be developed that 
did not exclude problems that were central to all of the minority groups represented. 
And in the event, the procedure seems to have been highly successful. 

Before the panel convened in Atlanta, the members were asked to help determine the 
extent to which each of the problem statements affected their constituencies. This was 
done in order to familiarize them with the statements and to aid them in forming their 
opinions as to which problems should be addressed. Each panel member was given a list 
of all of the problem statements and asked to answer two questions about each 
statement: 

• What percentage of the people in your subgroup (visually impaired, deaf, etc.) do 
you think are affected by this problem? 

How confident are you that your answer to the above is correct— expressed as a 
percentage? 

So, for example, to the statement, "Ramps are difficult for me," the panel member who 
uses crutches answered as follows: 

"70% of those who use crutches would concur with the statement and I am 60% 
certain that my estimate is reliable." 

After completing this task each panelist was asked to rank order a list of 18 problem 
areas— the problem areas being groupings of problem statements. 



99 



The overall rankings generated by the panelists are as follows: 

1. Safer and easier ways to cross streets. 

2. Provision for changing levels (nonmechanical). 

3. Fire emergency provisions for the elderly and handicapped. 

4. The design and location of mailboxes, parking meters, litter boxes, street lamp 
poles and signs, and other street furniture. 

5. Signs and signal lights. 

6. The problems at curbs, and curb ramp design. 

7. Better location of cues for the visually handicapped. 

8. The provision of toilet facilities, accessible to elderly and handicapped pedestrians 
using the streets. 

9. Lighting and illumination at night. 

10. The design of doors of all sorts. 

11. The lack of places to rest in safety and comfort. 

12. The design of elevators and their control system. 

13. The design and provision of handrails and guardrails. 

14. The design of materials used for walkways. 

15. The design of escalators. 

16. Parking and automobile access and egress problems. 

17. The affects of street crime. 

18. Congestion and crowding on walkways. 

Again, the purpose of this task was to assist the panel member in formulating their 
veiws of the most urgent and the most important needs of their constituents. Not all of 
these statements fall within the scope of the project, but for this stage of the process, 
an overview of the whole list of problem statements was sought. 

After completing these two tasks, the panelists were brought to Atlanta for a two day 
meeting. The goal of the meeting was to arrive at a consensus opinion in the form of a 
list of the most important problem areas that should be examined during the rest of the 
project. A second goal was to discuss these problem areas and to suggest possible 

100 



counter measures that could be evaluated. 

At this stage, several of the previously ranked problem areas were removed from 
consideration for the following reasons: 

• Fire emergency provisions— outside the scope. 

• Signs and signal lights—being considered in another study. 

• The design of doors— outside the scope, and being considered in another study. 

• The design of elevators— outside the scope, and being considered in another study. 

• The design of escalators— outside the scope. 

The panel agreed that all of the remaining problem areas should be considered further, 
with the greatest emphasis being placed on those with the higher rankings. 

In the final phase of the work of the panel, a large number of potential countermeasures 
were discussed and several of these were later developed for evaluation. These include: 

• Design parameters for short ramps. 

• Several different curb ramp layouts. 

• The layout of street furniture to assist the visually impaired. 

• The use of surface textures to inform the visually impaired. 

• Restrictions in the right-turn-on-red rule in certain circumstances. 

• Widened crosswalks. 

• Accessible pedestrian islands on wide streets. 

• A painted vehicular warning pattern for mid-block crossings. 

• Extended sidewalks at certain intersections. 

• Painted warnings to emphasize existing hazards such as manhole covers, and 
gratings. 

These countermeasures have been evaluated either in laboratory studies or in the field, 
and this work is described in Volume 3, "The development and evaluation of 
countermeasures." Finally, the results of these studies have been incorporated into the 
"Implementation Package". 



101 



introduction 

The first legislative steps directed at the elimination of architectural barriers have 
occurred only within the past two decades. As an emerging area of legislation, barriers 
removal laws lack definition and remain in a state of flux.. Definitions of such words as 
"handicapped," "disabled," and "rehabilitation" have had to be considered and scrutinized 
so that on the one hand they do not exclude people who are in need of assistance, but on 
the other hand do not become so inclusive that they refer to the entire population. 

On the positive side, in this fairly short time span national legislation has been enacted, 
and all of the states now have barriers removal laws. The American National Standards 
Institute has generated a standard which forms the basis for most barriers removal 
regulations (and their standard is currently being completely reexamined). 

On the negative side, however, there are quite bewildering differences in the 
approaches to the laws enacted and their interpretation. Compliance with these 
statutes has been inadequate. There are too many loopholes, too little enforcement, 
and too few sanctions for noncompliance. Much of the legislation, particularly at the 
state level, affects a comparatively small part of the constructed environment. 

For the elderly and handicapped pedestrian , the legislation has had little impact up to 
now because it has been primarily directed at buildings and, in particular, at buildings 
financed with federal or state funds. The sidewalks, streets, street crossings, public 
open spaces, parking lots, building sites, shopping centers, parks and recreation areas 
that are under the legal control of cities, towns, counties and local authorities remain 
substantially inaccessible and unaffected by legislative mandates to remove barriers. 

The legislative review that is the subject of this report was carried out as part of a 
much larger literature review directed at examining the state-of-the-art of providing 
for elderly and handicapped pedestrians. The search is not an in-depth analysis of all 
legislation that addresses architectural barriers. It is not directed, primarily, at 
barriers within buildings, nor does it discuss legislation at levels below that of states. 
The survey of states includes legislation through the middle of 1975, and the other 
sections include materials to the middle of 1977, plus certain significant federal laws 
passed late in 1977 and during 1978. 

This part very briefly charts society's changing view of handicapped people and how this 
has affected legislation; discusses the most significant federal laws and regulations and 
standards; compares the laws of the fifty states and the District of Columbia (up to the 
middle of 1975); briefly discusses the national construction codes and standards and 
their provisions including the American National Standards Institute Standard Specifica- 
tions; deals with the private sector; draws conclusions and makes some suggestions for 
the future development of measures to improve the effectiveness of legislation aimed 
at barrier-free design. 



102 



history 

Society's perceptions of and attitudes toward handicapped people have varied greatly 
over time and from place to place. To some cultures handicapped individuals were 
perceived as a threat to the fitness, and therefore the survival, of those particular 
groups. Early Roman law, for example, allowed a father to destroy his handicapped 
children. On the other hand, early Christians regarded physical disability as a way to 
salvation. But it was not until 1601 that the Poor Relief Act was passed in England. 
This act provided the first evidence that society was willing to accept handicapped 
people as part of society and undertake a measure of responsibility for them. 

In most countries, programs for the care and training of physically handicapped children 
and adults began with private and voluntary organizations, which brought to public 
attention the needs of the handicapped by establishing and maintaining direct service 
projects. Modern programs for physically handicapped people developed from the 
activities of organized charities which started in the nineteenth century. Throughout 
the twentieth century government agencies have assumed increasing responsibility for 
providing services to handicapped people, with private agencies supplementing these 
public services where there was a perceived need. 

In 1917, soon after the United States entered World War I, the first rehabilitation center 
in the United States was established. This was the Red Cross Institute for the Disabled, 
now called the Institute for Crippled and Disabled, in New York City. In the same year, 
Minnesota passed a law that provided for vocational rehabilitation; and Massachusetts 
foUowed suit in 1918. 

Congress became interested in vocational rehabilitation and gave money to states for 
programs. As a result, the 1917 Smith-Hughes Act, Public Law 347, which was aimed at 
vocational education, was enacted. This was followed by the Rehabilitation Act of 
1920, which promoted vocational rehabilitation for those disabled in industry. However, 
it did not provide for medical and physical restoration services. Rehabilitation services 
for the war-disabled were authorized the previous year. 

By World War n, the need to keep large numbers of people in the work force and to 
assist those disabled in the war gave the program new impetus. In 1941, President 
Roosevelt asked for a plan for rehabilitation services, but the emphasis was still 
primarily economic. The Barden Bill, Public Law 113, which resulted from this thrust 
provided further assistance to states for vocational rehabilitation including additional 
types of services such as transportation, tools, and equipment. 

In 1943, the Office of Vocational Rehabilitation was established, and the emphasis 
began to change, partly as a result of amendments to Federal legislation. It became 
clear that disability was no handicap to war production, and employment of the 
handicapped was deemed "a rational and cultural economic necessity in a healthy 
society." 

In the states, vocational rehabilitation was given new status accompanied by new rights 
and responsibilities. At that time the state vocational rehabilitation agencies were 
lacking in personnel trained to carry out the new responsibilities, but this potential 

103 



drawback resulted in greater cooperation among many agencies and organizations 
through mutual need. 

With the end of the war, disability was perceived as a problem of great magnitude. In 
addition to disabled veterans, there was an increasing number of workers disabled by 
transportation and industrial accidents. The Vocational Rehabilitation Act Amendments 
of 1954 Public Law 83-565 were enacted to provide a stronger financial structure, 
training programs for professionals, better rehabilitation for a greater range of disabled 
people, and to authorize expansion of rehabilitation facilities. 

The first coordinated efforts toward removal of architectural barriers began in this 
country through the National Easter Seal Society for Crippled Children and Adults, and 
the President's Committee on Employment of the Handicapped. On May 1, 1959, in 
conjunction with the annual meeting of the President's Committee on Employment of 
the Handicapped, people interested in the problem of architectural barriers were asked 
to meet with the American Standards Association (now the American National 
Standards Institute— ANSI), and a task force was formed to develop a set of standards. 
The Easter Seal Society provided the principal financial support. Leon Chatelain, Jr., 
an architect, became Chairman of the task force, and Timothy Nugent, Secretary. 
People from some fifty groups concerned with the problem participated. A review of 
the Department of Labor guide on this topic and studies of barrier-free design were 
carried out at the University of Illinois under Nugent, who had been a leader in 
establishing standards for his university. The University of Illinois became a testing 
ground for proposed American National Standards Institute Standard Specifications. 

On October 21, 1961, the American Standard Specifications for Making Buildings and 
Facilities Accessible to, and Usable by, the Physically Handicapped was approved by the 
American Standards Association and labeled ASA A117. 1-1961, now American National 
Standards Institute Al 17.1-1961. Copies of the American National Standards 

Institute Standards were distributed by the President's Committee early in 1962 to 
heads of all federal departments and agencies, who were urged to incorporate the 
Standards into the planning and design of all new federal structures. 

During the 1960's, Iowa and Pennsylvania passed legislation requiring entrance ramps in 
state-owned buildings of over fifty thousand square feet of area. In 1962, 
Massachusetts passed the first state law to eliminate architectural barriers in public 
buildings. The Massachusetts law was based on a model but rather permissive bill 
designed by the Easter Seal Society for adoption by the states. Also in 1962, the 
Vocational Rehabilitation Administration set out on a three-year effort to support 
programs to eliminate architectural barriers. 

On May 7, 1963, South Carolina became the first state to adopt in full the Standard of 
the American Standards Association and make them mandatory. This set the precedent 
for other states, and the Council of State Governments, which encourages uniform state 
legislation, proposed draft legislation based on the South Carolina law and advice from 
the Vocational Rehabilitation Administration and other units of the Department of 
Health, Education and Welfare. The Council endorsed The Model Law in August of 
1964. 

104 



On November 8, 1965, the Vocational Rehabilitation Act Amendments of 1965, Public 
Law 89-333, became law. Section 15 of the Act established, in the Department of 
Health, Education and Welfare, a National Commission on Architectural Barriers to 
Rehabilitation of the Handicapped. Mr. Leon Chatelain, Jr., became Chairman of this 
ad hoc study group in 1966. The Commission was to study the general problems of 
making facilities and structures of all kinds available to handicapped people. The study 
concerned public and private sector activities regarding the extent to which 
architectural barriers impeded access to, or use of, facilities in all types of buildings. 
The first report, completed in 1967, recommended that legislation be enacted to 
require: that all Health, Education and Welfare facilities intended for use by the public 
and leased or owned by the Federal government be designed barrier-free; that barriers 
be removed from existing Federal buildings used by the public to the fullest extent 
feasible; that non-Federal organizations which receive Federal funds for construction 
directly or through grants to states meet the same Federal standards; that the 
Department of Health, Education and Welfare play a major role in working with other 
executive agencies to develop standards. These recommendations were substantially 
adopted in legislation introduced in the House, H.R. 6589. State Divisions of 

Vocational Rehabilitation were expected to concern themselves with the problem and 
were deemed important in carrying out direct assistance programs under Public Law 89- 
333. The Commission looked to state agencies for ideas and suggestions. The 
Department of Health, Education, and Welfare gave guidance by issuing its Facilities 
Planning and Construction Manual , which incorporated American Standards Association 
Standards and applied the standards to all construction authorized by Health, Education 
and Welfare. The Vocational Rehabilitation Act was further amended in 1967, and in 
1968, " when the temporary authority for the Commission's activities was no longer 
valid, the language in the Act relating to the Commission was deleted. 

Sections, 202, 221 and 231 of the Housing Act of 1964, Public Law 89-117, provided for 
a wide range of federally assisted housing programs designed to meet the need for 
suitable housing for the handicapped. Previously the only FederaJ housing program for 
people with service-related handicaps was in the Veterans Administration. By 1965, the 
Housing Act, Public Law, 89-117, gave parity to the handicapped and elderly for low- 
rent housing. 

These laws marked the beginning of increased legislation benefitting handicapped and 
elderly people. With the passage of the "Architectural Barriers Act" in 1968, there 
started a new era of significant attention to the needs of elderly and handicapped 
individuals, especially with regard to barrier-free design. 

most significant recent federal laws 
affecting barrier-free design 

Many laws have been enacted by Congress in recent years which reflect the growing 
awareness of the needs of handicapped individuals to become participating United 
States citizens and their dissatisfaction with various Federal agencies' attempts at 
meeting these needs. One mandate of the legislation was that facilities used to house 



105 



programs in which disabled people wish to participate be accessible. Following are the 
most significant of these laws. 

1. "Architectural Barriers Act" (Public Law 90-480, 1968). An Act to Ensure that 
Certain Buildings Financed with Federal Funds ace so Designed and Constructed as 
to be Accessible to the Physically Handicapped . 

Congress recognized that approximately twenty-two million physically handicapped 
people were restricted in their movements and that these people were a valuable asset 
to society and must be afforded every opportunity to enter the mainstream of American 
life. Congress also realized that it had to mandate minimum accessibility standards 
since voluntary barrier-free standards had not assured disabled people total accessibility 
to and utilization of Federal Government programs. The historical activity and concern 
for access for the elderly and handicapped was a prologue to Public Law 90-480, the 
"Architectural Barriers Act" of 1968. This law states: 

"...the term 'building' means any building or facility (other than (A) a privately 
owned residential structure and (B) any building or facility on a military 
installation designed and constructed primarily for use by able-bodied military 
personnel) the intended use for which either will require that such building or 
facility be accessible to the public, or may result in the employment or residence 
therein of physically handicapped persons... which is constructed, altered or leased 
on behalf of the United States, or is financed by a grant or loan made by the 
United States subject to this Act. Every building designed, constructed, or altered 
after the effective date of a standard issued under this Act which is applicable to 
such building, shall be designed and constructed, or altered in accordance with 
such standard." 

The General Services Administration, in consultation with the Secretary of Health, 
Education and Welfare, "...is authorized to prescribe such standards...." The Secretary 
of Housing and Urban Development, and also the Secretary of Defense, each in 
consultation with the Secretary of Health, Education and Welfare, is authorized to 
prescribe standards for their departments "...to insure that physically handicapped 
persons will have access to, and use of, such buildings." The Administrator of General 
Services, with respect to standards issued under this Act, is authorized: 

1. To modify or raise any such standard on a case-by-case basis, upon application 
made by the head of the department, agency, or instrumentality of the United 
States concerned, and upon a determination by the Administrator or Secretary, as 
the case may be, that such modification or waiver is clearly necessary; and 

2. To conduct such surveys and investigations as he deem necessary to insure 
compliance with such standards. 

The "Architectural Barriers Act" has been amended twice. The first time was on 
March 5, 1970, following a hearing in December of 1969 before the Subcommittee on 
Public Buildings and Grounds and the Committee on Public Works of the House of 
Representatives. This became Public Law 91-205 Washington Metropolitan Area 
Transit , '' and brought the Washington Metropolitan Area Transit System under the 

106 



scope of the Act. This legislation was needed since the Washington Metropolitan 
Transit Authority technically is not a Federal agency. It is significant that legislative 
history clearly reflects that rolling stock is not subject to, or covered by, Public Law 
90-48CL The second amendment, Public Law 94-541, Title,!! , was passed October 18, 
1976. It reflects changes as noted in the first Report by the Architectural and 
Transportation Barriers Compliance Board, established under the Rehabilitation Act of 
1973. 

That amendment identified four reasons why there was non-compliance with the 
Architectural Barriers Act of 1968. 

1. The law contained exemptions for the Department of Defense and the Department 
of Housing and Urban Development; 

2. Many federally funded buildings were under design, construction or modification 
when the bill was passed, and many existing federal facilities remained essentially 
inaccessible; 

3. There was a lack of funding to hire adequate staff to conduct compliance surveys 
and investigations; and 

4. There was a lack of enforcement because deficiencies found through investiga- 
tions could only be reported to the involved agency. 

This new legislation (Public Law 94-541, shown in Table 16) reflects a continued 
awareness of the need for barrier-free design and clearly mandates that those Federal 
agencies enumerated in the "Architectural Barriers Act" ensure that public buildings be 
made accessible to physically handicapped people by changing permissive language such 
as "is authorized to prescribe" to "shall prescribe." The section on leasing was 
strengthened to include all leased buildings or parts thereof, including renewals of 
leases and leases of buildings for subsidized housing programs which must be accessible 
and usable after January 1, 1977. Postal Service buildings are now covered under the 
Act. The General Services Administration must now report annually to Congress and to 
those other groups covered under the "Architectural Barriers Act"; and the Architec- 
tural and Transportation Barriers Compliance Board is to report on its compliance 
activities to the Public Works and Transportation Committee of the House of 
Representatives and the Environment and Public Works Committee of the Senate. 
These requirements reflect the expectation of Congress that the Architectural and 
Transportation Barriers Compliance Board will responsibly execute its mission. 

2. Rehabilitation Act of 1973, Public Law 93-112 . Title V. 49 

Section 501 - Employment of Handicapped Individuals . 

This section provides "a focus for Federal and other employment of handicapped 
individuals" to be enforced by the Civil Service Commission. 



107 



Table 16: Affirmative Action Provisions of the Rehabilitation Act 
Of 1973, as Amended 



( 

SECTION OF ACT 


TITLE OF SECTION 


COVERAGE 


PROVISIONS 


ADMINISTERING 
AGENCY 


APPLICABLE REGU-l 
LATIONS 


Section 101 (a) (6) 


VR State Plan 
Administration 


State rehabilitation 
agencies and facili- 
ties 


Agency to take affir- 
mative action to em- 
ploy and advance in 
employment qualified 
handicapped individ- 
uals 


Rehabilitation Servi- 
ces Administration 


Federal Register 
Vol. 4C, No. 75, pp. 
54696-54731, Novem- 
ber 25, 1975 


Section 501 


Employment of Hand- 
icapped Individuals 


Departments, agen- 
cies and instrumen- 
talities in the execu- 
tive branch of the 
Federal Government 


Agency to have affir- 
mative action pro- 
gram for hiring, 
placement and ad- 
vancement of handi- 
capped individuals. 
Plan to be updated, 
reviewed and approv- 
ed annually 


U. S. Civil Service 
Commission 


U.S. Civil Service 
Commission, Federal 
Personnel Manual, 
Chapter No. 306 


Section 502 


Architectural and 
Transportation Bar- 
riers Compliance 
Board 


Composed of the 
heads (or designees) 
of nine federal agen- 
cies 


To insure compliance 
on accessibility and 
usability of buildings 
constructed with 
Federal funds; to in- 
vestigate, examine 
and recommend 
methods of eliminat- 
ing architectural, 
transportation and 
attitudinal barriers 
confronting handicap- 
ped persons 


Architectural and 
Transportation Bar- 
riers Compliance 
Board 


Architectural Bar- 
riers 

Federal Register, 
Vol. 41, No. 128, pp. 
27192-27196, July 1, 
1976 


Section 503 


Employment under 
Federal Contracts 


Contractors of the 
Federal Government 
with contracts of 
$2500 or more 


Contractor to take 
affirmative action to 
employ, advance in 
employment and 
otherwise treat hand- 
icapped individuals 
without discrimina- 
tion based on their 
handicap in all em- 
ployment practices 


Office of Federal 
Contract Compliance 
Programs, Depart- 
ment of Labor 


Federal Register, 
Vol. 41, No. 75, pp. 
16147-16155, April 
16,1976 


Section 504 


Nondiscrimination 
under Federal Grants 


All programs and ac- 
tivities receiving fed- 
eral financial assist- 
ance 


No qualified handi- 
capped individual 
shall, on the basis of 
handicap, be excluded 
from, be denied the 
benefits of, or other- 
wise be subjected to 
discrimination under 
any program or activ- 
ity receiving federal 
financial assistance 


Office of Civil Rights 

Department of Health 
Education and Wel- 
fare 


Proposed Regulations 
Federal Register, 
Vol. 41, No. 138, pp. 
29548-29567, July 16, : 
1976 

J 



Section 502 - Architectural and Transportation Barriers Compliance Board . 

Section 502 established an Architectural and Transportation Barriers Compliance 
Board, composed of heads of, or their executive level designees, from eight agencies: 
the Department of Health, Education and Welfare; Department of Transportation; 
Department of Housing and Urban Development; Department of Labor; Department of 
the Interior; General Services Administration; United States Postal Service; and the 
Veterans Administration. 



108 



The Board shall: 

(1) Insure compliance with standards set down by General Services Administration, 
Department of Defense, and the Department of Housing and Urban Development 
in accordance with the "Architectural Barriers Act" of 1968, (Public Law 90-480) 
as amended by the Act of March 5, 1970, (Public Law 91-205) ; 

(2) Investigate alternative approaches to architectural, transportation, and attitudinal 
barriers; 

(3) Determine necessary measures to be taken by various governmental levels to 
correct these barriers; 

(4) Promote and use the International Accessibility Symbol; and 

(5) Make reports and recommend necessary legislation and administration to the 
Congress and the President. 

The Compliance Board also shall determine how and to what extent transportation 
barriers impede mobility of elderly and handicapped people and ways in which travel 
expenses to and from work can be met or subsidized when such people are unable to use 
mass transit systems, or need special equipment in private transportation; and consider 
needs for housing for handicapped persons. It shall determine measures being taken to 
eliminate barriers from present and future transportation systems and to make housing 
available and accessible to handicapped persons or meet sheltered housing needs. In 
addition, the Board shall prepare proposals for goals for adequate housing and 
transportation systems including ways to bring cooperative effort among agencies, 
organizations and groups already involved or whose cooperation is essential to a 
cooperative effort. The Board shall conduct investigations, hold public hearings and 
issue orders to insure compliance. An order of compliance issued by the Board shall be 
a first order for purposes of judicial review. The Board may appoint as many hearing 
examiners as needed. The department or agencies involved in this Act shall supply 
assistances. 

From the foregoing statements, it appears that the reasons for non-compliance with the 
"Architectural Barriers Act," Public Law 90-480 stated by the Compliance Board in its 
first annual report were noted and remedial legislation passed. 

Section 503— Employment Under Federal Contracts 

This section states: "Any contract in excess of $2500 entered into by any Federal 
department or agency for the procurement of personal property and non-personal 
services (including construction) for the United States shall contain provision that, in 
employing persons to carry out such contract, the party contracting with the United 
States shall take affirmative action to employ and advise in employment qualified 
handicapped individuals as defined in Section 7 (6)." This section is enforced by the 
Department of Labor, and does not include exclusively private activities. 



109 



Section 504— Non-discrimination Under Federal Grants . 

"No otherwise qualified handicapped individual in the United States, as defined in 
Section 7 (6), shall, solely by reason of his handicap, be excluded from participation in, 
be denied the benefits of, or be subjected to discrimination under any program receiving 
Federal assistance." Enforcement of this section is the responsibility of the 
Department of Health, Education and Welfare, including the Office of Civil Rights, 
Section 504, also, does not include private programs. 

The Rehabilitation Act Amendments of 1974, Public Law 93-156 . 

This amendment to Public Law 93-112, The Rehabilitation Act of 1973 , provides 
evidence of Congressional intent to increase its commitment to handicapped people. In 
Titles IV and V of the Act, the definition of handicapped people has become more 
global, with emphasis on major life activities instead of employment. It requires that 
state agencies and others who receive Federal funds under this title take affirmative 
action to employ and promote qualified handicapped persons; and that recreational 
activities be fully accessible. It adds the Department of Defense to the Architectural 
and Transportation Barriers Compliance Board (making the Board now composed of nine 
agencies); makes the Secretary of Health, Education and Welfare Chairman of the 
Compliance Board; and adds a consumer Advisory Panel, a majority of the members of 
which shall be handicapped individuals, to provide guidance, advice and recommenda- 
tions to the Board. It strengthens the power of the Compliance Board by authorizing 
the withholding of Federal funds to agencies found not in compliance. This Amendment 
also authorized the President to convene a White House Conference on Handicapped 
Individuals to "...develop recommendations and stimulate a national assessment of 
problems and solutions to such problems, facing individuals with handicaps." This 
Conference was held in May, 1977, and recommendations have followed. 

Rehabiliation, Comprehensive Services, and developmental Disabilities Amend- 
ments of 1978 . Public Law 95-602 (HR-12467) . 

Relative to the Rehabilitation Act of 1973: Titles I through III have been expanded, 
Title IV has been replaced with one entitled the "National Council on the Handicapped," 
Title VI, the "Employment Opportunities for Handicapped Individuals Act", and Title VII, 
"Comprehensive Services for Independent Living", have been added. Title V amends the 
Developmental Disabilities Services and Facilities Construction Act and is entitled the 
"Developmental Assistance and Bill of Rights Act." 

This act extends basic programs established in the Rehabilitation Act of 1973. Certain 
changes have been made to some of these programs, however. These include: 

(1) A revised allocation formula for Vocational Rehabilitation Services monies; 

(2) Research and Training Centers are moved under a newly established National 
Institute for Handicapped Research instead of the Rehabilitation Services 
Administration and allows research and demonstration projects for children and 
elderly; 

110 



(3) Grants may be awarded to operate Comprehensive Rehabilitation Centers to 
provide a broad range of services; 

(4) A community services employment program for handicapped individuals is 
established; 

(5) A National Council for the Handicapped is established and; 

(6) Comprehensive services for independent living for handicapped individuals are 
provided. The Act also amends the Developmental Disabilities Services and 
Facilities Construction Act to revise and extend the programs under the act and 
changes the Developmental Disabilities definition. 

Funds have not, as of December, 1978, been appropriated. Appropriation remains 
under a continuing resolution. 

3. Executive Order 11914 was issued on April 28, 1976 by President Ford. It 
"directed the Secretary of Health, Education and Welfare to coordinate the 
Government-wide implementation of Section 504 and to define handicapped 
persons and discriminating practices. Each grant-making agency was directed to 
issue regulations consistent with HEW's." 

"In May of 1977, HEW issued its final substantive section 504 regulation 
(42FR22676, May 4, 1977) and in January of 1978 it issued a regulat^n to 
implement its Executive order responsibility (43FR2132, January 13, 1978"). 

54 

4. Final Rule , General Services Administration ensures that buildings leased by the 

Federal Government, as well as Federal buildings, have accomodations for the 
physically handicapped. 

Other important items include: 

(1) The Architectural and Transportation Barriers Compliance Board has been 
extended and provided improved remedies and increased funding, 

(2) Client assistant programs have more than doubled in funding, 

(3) Special projects are provided for migratory workers projects, reader services 
for the visually impaired, the Helen Keller National Center, interpreters 
services for the deaf, and start-up grants for special recreation programs, 

(4) Protection and advocacy for rights of the disabled, 

(5) Grants for independent living services for older visually impaired (over 55), 

(6) Special studies for rural rehabilitation and disincentives to employment, 

(7) Section 504 of Title V of the 1973 Rehabilitation Act now applies to the 
Federal Government. 

Ill 



5. Tax Reform Act of 1§76, Tax Reduction for Removal of Architectural and 
Transportation Barriers , Public Law 94455. This Act provides that costs, up to 
$25,000 for three years, incurred to make any facility or public transportation 
vehicle owned or leased by a taxpayer for use in connection with his trade or 
business more accessible to and usable by handicapped and elderly individuals are 
tax deductible. (Usually costs incurred to improve such property must be 
capitalized and depreciated over the useful life of the property.) The definition 
of handicapped people is identical to that used in the Rehabilitation Act of 1973. 

6. Department of Transportation laws affecting transportation for elderly and 
handicapped persons . 

Urban Mass Transportation Act of 1964, Public Law 88-365, as amended in 1970, Public 
Law 91-453 , Section 16 declared that it is a "national policy that elderly and 
handicapped persons have the same right as other persons to utilize mass transportation 
facilities and services that they can effectively utilize." Under Section 6, 1?% of funds 
may be set aside and used to increase information and technology for elderly and 
handicapped mass transportation needs. Title HI, Section 16(b) of the Federal Highway 
Act of 1973, Public Law 93-87 amends Public Law 91-453 by stating that the 
Secretary "may" set aside 2% of funds to finance programs 

(1) to states and local public roads for providing mass transportation services; 

(2) to private non-profit corporations which provide transportation services meeting 
the special needs of elderly and handicapped people. 

Title I of this law, Section 165(b) states that the Secretary "shall assure" that 
transportation projects receiving Federal assistance under sections of the Act will be 
planned, designed, constructed, and operated to be effectively used by elderly and 
handicapped people. Federal Aid Highway Act Amendment of 1974, Public Law 93- 
643 Section 105(b) amends Section 165(b) of Public Law 93-87 to read "shall require." 
Section 228 requires curb cuts or ramps at crosswalks on streets constructed after July 
1, 1976. 

Department xtf Transportation and Related Agencies Appropriation Act of 1975 Public 
Law 93-391 , Section 315 states that rail or subway cars, buses and facilities will not 
be funded by the Act unless designed to meet mass transportation needs of elderly and 
handicapped people. 

Urban Mass Transportation Act of 1964~as amended by the National Mass Transporta- 
tion Act of 1974, Public Law 93-503 , Section 5(m) requires assurances that rates 
charged elderly and handicapped people in non-peak hours on the transportation projects 
supported by this section will be half the rate normally charged. Section 108 states that 
"nothing contained in this title shall require the charging of fares to elderly and 
handicapped persons." 

During 1975, Urban Mass Transportation Agency received $20.8 million for forty-nine 
projects to provide capital equipment and facilities for use by non-profit organizations 

112 



to provide transportation for elderly and handicapped. Many grants during the year 
involved funds for special vehicles (usually vans) for the use of handicapped passengers 
or for the provision of special equipment, such as lifts, on regular buses. Urban Mass 
Transportation Act's new requirements for Transbus provide low steps and wide doors 
and a ramp or lift for passengers in wheelchairs. The Urban Mass Transportation Act as 
amended through February, 1976 provides that all Mass Transportation provide for easy 
accessibility for elderly and handicapped people. 

7. Older Americans Act of 1965 as amended in 1973, Public Law 9329 . 61 

This Act has been amended three times since 1965. The original Act established an 
Administration on Aging. The Amendments strengthen programs to combat the most 
pressing problems of older Americans such as lack of transportation andjioor nutrition. 
The Older American Act of 1965 as amended in 1974, Public Law 93-351 , calls for 

(1) Housing for older persons suffering from physical disabilities; 

(2) Providing services to assist in meeting the particular needs of physically and 
mentally impaired older persons, to assist them to lead more independent lives; 
and 

(3) Multi-purpose senior centers, constructed in compliance with the Architectural 
Barriers Public Law 88-560 . 

8. The Housing and Community Development Act of 1964 . 

This act provided for a wide range of needs for accessible housing for elderly and 
handicapped people. The 1964 Housing and Community Development Act funded over 
500,000 dwelling units for elderly and handicapped individuals. The Housing and 
Community Development Act of 1974 asks for approval of local housing stock for 
lower income persons including handicapped and elderly. It also stipulates that a 
Community Development Program may include special projects aimed at eliminating 
architectural barriers. The Housing and Community Development Act of 1977 (HR 6655 
and S207) appears to be even more far-reaching. 

federal regulations and standards 

The Public Buildings Act of 1959, Public Law 86-249 as amended provides for financing 
acquisition, alteration, maintenance, operation and protection of buildings housing the 
civilian activity of the Federal government, and authority for this was given to the 
General Services Administration. General Services Administration's general functions 
include establishing policy and providing for the government an economical and 
efficient system for management of its property and records, including construction and 
operation of buildings, utilization and disposal of property, transportation, traffic and 
communications management, as well as other appropriate functions. 

43 
The "Architectural Barriers Act," Public Law 90-480 , passed in 1968, requires the 

heads of General Services Administration, Housing and Urban Development, and 

113 



Department of Defense in consultation with the Secretary of Health, Education and 
Welfare, to issue standards for Federal buildings which include those buildings and 
facilities constructed or altered on behalf of the United States government; buildings 
leased after alterations in accordance with Federal specifications; and buildings funded 
by grants or loans where the state authorizing the grant or loan also authorizes the 
imposition of construction forms and conditions. The heads of the three enumerated 
agencies may waive standards relative to accessibility and usability on a case-by-case 
basis only upon application by the head of another department or agency. 

Public Law 94-541 imposes a clear statutory mandate that General Services Administra- 
tion, Housing and Urban Development, Department of Defense and United States Postal 
Service ensure that public buildings are made accessible to the physically handicapped 
by requiring them to issue standards. 

The Rehabilitation Act of 1973, Public Law 93-112 , established the Architectural and 
Transportation Barriers Compliance Board (ATBCB) and mandated it to ensure 
compliance with the standards prescribed by the General Services Administration, 
Department of Defense, Housing and Urban Development and United States Postal 
Service pursuant to the "Architectural Barriers Act" of 1968 as amended. To carry out 
this mandate, the Board: 

(1) Conducts investigations to determine compliance of Federal agencies with new 
accessibility standards; 

(2) Holds hearings to collect or determine public opinion; and 

(3) Issues orders necessary to ensure compliance with the provisions of the Act, which 
is a final order. 

The Rehabilitation Act Amendments of 1974, Public Law 93-516 , gave the Board power 
to enforce compliance by withholding or suspending funds with respect to non-complying 
buildings. Regulations implementing Section 504 of the Rehabilitation Act of 1973 
became effective June 3, 1977 and specify the American National Standards Institute 
Standard Specifications as the conforming standard. These regulations require, among 
other things, that all programs or activities and facilities must be accessible; employers 
may not refuse to hire qualified 'handicapped people if reasonable accommodations can 
be made; every handicapped child will be entitled to free public education appropriate 
to needs and must not be segregated; and all recipients of Health, Education and 
Welfare Funds must complete a self evaluation. These regulations will have far- 
reaching effect with regard to barrier-free design over the years to come. Rehabilita- 
tion, comprehensiveness, and developmental disabilities amendments of 1978, Public 
Law 45-602 has not had regulations promulgated as of December, 1978. 

The General Services Administration, in consultation with the Department of Health, 
Education and Welfare, developed implementing regulations, Federal Property Manage- 
ment Regulations , (FPMR), Sub-part 101-19.6, "Accommodations for the Physically 
Handicapped." These regulations replaced the earlier set of Regulations 101-17.7. The 
Federal Property Management Regulations prescribe the use of the "American National 
Standard Specifications for Making Buildings and Facilities Accessible to, and Usable 

114 



by, the Physically Handicapped^' No. Al 17.1-1961 (American National Standards 
Institute Standard Specifications). 

The following are brief descriptions of regulations and/or standards used by various 
departments. As indicated earlier all but certain Housing and Urban Development, 
Department of Defense and Postal Service facilities fall under the Federal Property 
Management Regulations 101-19.6 which require compliance with the American 
National Standards Institute Standard Specifications. Agency standards described are in 
addition to, or supplement, American National Standards Institute Standard Specifica- 
tions. A few will be given as illustrations. 

1. The Department of Health, Education and Welfare . Health, Education and 
Welfare uses the American National Standards Institute Standard Specifications, 
and their Technical Handbook supplements and amplifies Federal Property 
Management Regulations and the American National Standards Institute Standard 
Specifications. Buildings leased or owned by Health, Education and Welfare follow 
the American National Standards Institute Standard Specifications. Health, 
Education and Welfare funded facilities follow the Technical Handbook: Technical 
Handbook for Facilities Engineering and Construction Manual (Part 4, Facilities 
Design and Construction 4.00, Architectural Section 4.12, "Design of Barrier-Free 
Facilities".) The Health, Education and Welfare interpretation of the American 
National Standards Institute Standard Specifications is much more inclusive and 
better illustrated than the American National Standards Institute Standard 
Specifications. Health, Education and Welfare has responsibility for compliance 
with Section 504 Regulations of the Rehabilitation Act of 1973. 

2. Veterans Administration . The Veterans Administration has supplemented the 
American National Standards Institute Standard specifications and has produced 
related standards: Accommodations for the Physically Handicapped: Veterans 
Administration Construction Standard CD-28 , dated October, 1973, Office of 
Construction, United States Veterans Administration, 810 Vermont Avenue, N.W., 
Washington, DC 20420. The Veterans Administration regulations have been 
historically among the most widely encompassing standards since they include 

(1) Construction or alteration; 

(2) Leasing or renting; 

(3) Loans or grants. 

Veterans Administration regulations continue to be updated. The only exclusion is 
a privately owned residential facility. 

3. Department of Defense (POD) . This Department has issued a number of 
regulations and among the best is "Design for the Physically Handicapped" EM 
1110-1-103, 10/15/76, issued by the Department of the Army. 

4. Department of Housing and Urban Development (HUD) . Housing and Urban 
Development follows American National Standards Institute Standard Specifica- 

115 



tions and The Code of Regulations , Title 24, Housing and Urban Development. 
Housing and Urban Development has contracted to develop new standards. 

5. Department of Transportation/UMTA/FHWA . Federal Register, Vol. 41 , #85, 
Friday, April 30, 1976, Pages 18, 234, and 18, 241, "Transportation for Elderly and 
Handicapped Persons." Title 49, Chapter VI, Section 609.13 "Fixed Facilities," 
states that all stations, terminals, buildings or other facilities, except those not 
intended for the public or physically handicapped persons, designed, constructed or 
altered on or after May 31, 1976 with Urban Mass Transportation Act assistance 
and intended for use by the public or for those handicapped individuals who may be 
employed will be altered in accordance with minimum standards approved in 
accordance with American National Standards Institute. Also, regulations are 
promulgated for rapid rail vehicles in Section 609.17. 

After September 30, 1979, all buses purchased with Department of Transportation 
grants shall have a floor height no greater than twenty-two inches, capable of 
kneeling to eighteen inches above the ground and be equipped with a ramp for 
boarding. This vehicle is called Transbus. Department of Transportation has 
also put out a group of publications called Technology Sharing , among which is 
"Transportatiqiuand the Elderly and Handicapped." ' "Tips on Care and Safety for 
Deaf Drivers" is also one of several publications of assistance to handicapped 
and elderly people put out by Department of Transportation. 

The Federal Aviation Administration (FAA) has an internal policy memo requiring 
compliance with American National Standards Institute Standard specifications, 
and, an advisory circular on Air Transportation and Handicapped Persons , AC 120- 
32, the most recent one being issued on March 25, 1977 as guidelines for airline 
personnel. Federal Aviation Administration (FAA) issued proposals regarding 
handicapped people. Comments were received, many of which were critical. 
Tests were carried out to provide further information. 

The Coast Guard (under Department of Transportation in peacetime, and 
Department of Defense in war) prescribes American National Standards Institute 
Standard Specifications where feasible and appropriate. Department of Defense is 
now developing new standards to better meet needs. 

6. Department of the Interior . The Department of Indian Affairs uses the American 
National Standards Institute Standard Specifications and some additional stan- 
dards. The Park service has trails for the visually impaired. The Fish and Wildlife 
Service has placed emphasis on new public toilet facilities being made accessible. 
However, no regulations for national parks have been promulgated. 

7. Department of Labor . The Department of Labor comes under General Services 
Administration Regulations for Federal buildings. They have not developed 
regulations of their own since they seldom have facilities under their direction. 
The Department of Labor will enforce compliance with Section 503 Regulations of 
the Rehabilitation Act of 1973. 



116 



8. Department of Agriculture , The Forest Service uses the American National 
Standards Institute Standard Specifications for construction at recreation sites. 

state legislation (thru July, 1975) 

72 
A 1973 Survey of State Legislation to Remove Architectural Barriers prepared by the 

Commission on Barrier-Free Design, of the President's Committee on Employment of 

the Handicapped, showed that each of the fifty states had an architectural barriers law, 

and that the District of Columbia had an Executive Order. Effective dates of the 

legislation ranged from 1963 to 1971, with most falling in the mid-sixties. 

Forty-two states had adopted the American National Standards Institute Standards 
Specifications; forty-seven states required all publicly funded buildings to comply with 
the standards. Three states included only state buildings; five states included publicly 
used but privately owned buildings; thirteen states explicitly covered remodeling. 
Responsibility for enforcement was clearly delineated in fourteen states where school 
funds were involved. Enforcement responsibility varied from state to state. Waiver 
clauses granting exemptions were found in sixteen of the state codes. 

In 1973, ten states were drafting new legislation, nine of which proposed improvement 
of enforcement or increasing the scope of compliance; the content for the tenth was 
unknown at that time by the surveyors. Some of these proposed laws have since been 
introduced to the state legislatures. The 1973 study showed a great improvement over 
1967, when two surveys demonstrated that only thirty-three states had architectural 
barriers legislation in force. 

A new search of state legislation was conducted during the process of this literature 
review. From this study, it appears nearly all fifty states have new legislation pending 
or introduced. The Board of Examiners and Registrars of Architects of the Government 
of the District of Columbia stated in a letter to the author that it does not have an 
architectural barriers law or provisions in the District of Columbia building code. 
However, Executive Order No. 65-413 of March 30, 1965 states that all District of 
Columbia departments involved with construction of new public buildings shall "give 
consideration to the needs of handicapped people." 

A compilation of the material resulting from the study is presented in Tables 17 and 18. 
The following should be noted: 

(1) Many states in their responses did not clearly cross-reference pertinent 
information. This makes it difficult to find the legislation or standards; 

(2) Many states have permissive laws with broad waivers in them. Different 
interpretations are possible in many; 

(3) Most of the state laws or standards either stated that they used the American 
National Standards Institute Standard specifications, or appeared to use them 
totally or in part, even though the standards were not referred to directly in many 
cases; 

117 



Table 17: State Laws for Design and Enforcement 



r- a 


DESIGN 


CRITERIA 




Public- 
owned 
buildings 


Privately 

owned 

buildings 


ENFORCEMENT 


^ 


General 
Inclusions 


Complies 
with ANSI 
Standards 


Compared to 
ANSI Standards 


Sanctions 
for non- 
compliance 


Party 

responsible 
for enforce- 
ment: 
single-S 
multiple-M 


STATE 


More 
Inclusive 


Less 
Inclusive 


Alabama 


+ 


X 




X 






M 




Alaska 


X 






X 






S 


Arizona 


+ 


X 




X 






M 




Arkansas 


+ 






X 






S 


California 




X 




X 


X 




M 


Colorado 


+ 






X 






M 




Connecticut 






XI 


X 


X 




S 


Delaware 






X 








S 


D.C. 














Exec. Order 


Florida 


X 






X 


X 


X 




Georgia 


X 






X 






M 


Hawaii 


X 






X 






M 


Idaho 




X 




X 




X 


S 


Illinois 




X 




X 


X 


X 


S 


Indiana 


+ 






+ 






s+ 


Iowa 


+ 






X 


X 




s 


Kansas 


X 






X 






M 


Kentucky 






X 








M 


Louisiana 


X 






X 






S 


Maine 






X 


X 






M 


Maryland 


X 






X 






M 


Mass. 




X 




X 






M 


Michigan 


+ 






X 


X 


X 


M 


Minnesota 




X 




X 






S 


Mississippi 






X 


X 






s 


Missouri 






X 


X 






M 


Montana 


+ 






+ 






M+ 


Nebraska 


X 






X 






M 


Nevada 


X 






X 






2 


N.H. 


X 






X 






M 


New Jersey 


+1 






X 






2 


New Mexico 


+ 






X 






M+ 


New York 






X 


X 






M 


N. Carolina 




X 




X 


X 




S 


N. Dakota 






X 


X 






2 




Ohio 






X 


X 






S 


Oklahoma 






X 


X 






2 


Oregon 


+ 






X 


X 




S 


Perm. 






X 


X 




X 


S 


Rhode Island 


X 






X 






M 


S. Carolina 


+ 






X 




X 


M 




S. Dakota 


+ 






+ 






S+ 


Tennessee 




X 




X 






M 


Texas 


X 






X 






S 


Utah 


+ 






X 






M 


Vermont 


X 






X 






M 


Virginia 


+ 






+ 






S+ 




Washington 


X 






X 




X 


M 


W. Virginia 






X 


X 






S 


Wisconsin 






X 


X 


X 




S 


Wyoming 


X 






X 






S 



Key: 1. Proposed legislation more inclusive 
2. Not stated 

+ Stated in 1973 Legislative Survey by 

President's Committee on Employment of the 
Handicapped. 



* In part 

X Criteria stated in law 

# All individual criteria not given 
Single - One Agency 

Multiple - More than One Agency 



118 



Table 18. State Laws for Site Development, Buildings, Fixtures, 
Controls, Etc. 







Site 


Developm< 


snt 










Buildings 








Fixtures, 
Controls, Etc. 




State 


GO 

25 

< 


Efl 

3 

o 
«- 

u 


Ifl 

n 

3 

o 


co 

•o 

O 

o 

o 

bo 

c 

'•B 

CO 

L, 

O 


CO 

•D 

t~ 
cd 

IS) 

eg 
EC 


CO 

.22 

4-» 

'5 

CO 

PL, 

bo 
c 

15 

t- 

a. 


9 

o 

3 

3 
PL, 


CO 
cd 

CD 
CO 

a> 




in 
O 

12 

(-, 

o 

O 


CO 

>> 

00 

s 

(-, 

o 
o 
Q 

■a 

00 

«- 
O 
O 

Q 


co 

b 

o 

*•» 
cd 
> 
CD 

3 


10 

CD 

o 

§ 

i- 
+-» 

c 
w 


1/3 

t- 

o 
o 

*—* 


V. 

a. 
B 

CO 

Pi 


3 

CO 

■s 

c 

cd 
EC 

i 

to 

'3 
<-» 




10 

r— 1 

o 

c 
o 
U 


In 

CO 
CD 

Q 

in 

r— » 

CO 
!> 

to 

■a 

lO 

br 
C 
c 

a. 


c 

s 

CO 

■a 
& 

to 
•a 

CO 

he 

c 
'c 

t- 
CO 


10 

e 

'3 

c 

3 

o 

fcv, 

t_ 
CD 
■#-» 
CO 


to 

•o 

t-, 

CO 

■v 

25 CO 

1 55 

O -* 1 

.0 < 

E c 
>> — ■ 

M -o 

10 CD 
CO X) 
CD 3 


Comments 


Alabama 


+ 






X 


X 


X 


X 








X 


X 


X 


X 


X 


X 




XJ 


X 


X 


X 






Alaska 


+ # 














































Arizona 


+ 






X 


X 


X 


X 








X 


X 


X 


X 


X 


X 




X 


X 


X 


X 






Arkansas 


•t 






X 


X 


X 


X 








X 


X 


X 


X 


X 






X 






X 






California 


1 


X 


X 














X 






X 




X 










X 


X 


X 


Changing to 
own stands. 


Colorado 


+ 






X 


X 


X 


X 








X 


X 


X 


X 


X 


X 




X 


X 


X 


X 






Connecticut 


X# 












































1975 law 


Delaware 


+* 








X 


X 


X 








X 


X 


X 


X 


X 


X 




X 


X 


X 


X 






D.C. 














































Exec. Order 

#65-413 


Florida 


X 


X 


X 






X 


X 






X 


X 


X 


X 




X 






X 




X 








Georgia 


X 






X 


X 


X 


X 








X 


X 


X 


X 


X 


X 




X 


X 


X 


X 




Elevator 
segment 
weak 


Hawaii 


x# 














































Idaho 


x# 














































Illinois 




X 


X 


X 


X 


X 


X 








X 


X 


X 


X 


X 






X 


X 


X 


X 






Indiana 


+# 














































Iowa 


X 




X 


X 


X 


X 


X 








X 


X 


X 


X 


X 


X 




X 




X 


X 




"Insofar as 
feasible" 


Kansas 


x# 














































Kentucky 




X 


X 








































Pedestrians 
only 


Louisiana 


X 






X 


X 


X 










X 


X 


X 


X 


X 


X 




X 






X 






Maine 


+ 






X 






X 








X 


X 




X 


X 


X 






X 


X 


X 






Maryland 


+ 


X 


X 










































Massachusetts 












X 


X 








X 


X 


X 


X 


X 


X 




tx~ 


X 


X 


X 


X 




Michigan 


+# 




X 










































Minnesota 


+ 




X 


X 


X 


X 


X 






X 


X 


X 


X 


X 


X 


X 




X 


X 


X 


X 


X 


Less emphasis 
on deaf 


Mississippi 










X 


X 


X 








X 


X 


X 


X 


X 


X 




X 




X 








Missouri 






X 




X 


X 


X 








X 


X 


X 


X 


X 


X 












X 




Montana 


+# 














































Nebraska 


+ 






X 


X 


X 


X 








X 


X 


X 


X 


X 


X 




X 


X 


X 


X 






Nevada 


x# 














































N.H. 


X 
























X 




X 


















New Jersey 


+# 












































Proposed 
legislation 


New Mexico 


+# 




X 








































General only 


New York 








X 




X 


X 








X 


X 


X 




X 










X 


X 




State Univ. 
more inclu- 
sive 


N. Carolina 


+ 


X 


X 


X 


X 


X 


X 








X 


X 


X 


X 


X 


X 




A 


X 


X 


X 


X 




N. Dakota 


# 




X 






X 


































"Full con- 
sideration to 
ANSI" 
























1 










1 

















119 



Table 18. 



State Laws for Site Development, Buildings, Fixtures, 
Controls, Etc. (continued) 









































Fixtures. 








Site Development 




Buildings 




Controls, Etc. 
















































VI 










































fa-H 


T3 




•D 










































CO 


c 














































fl> 






CO 










































a 


CO 




X3 

_ c 










































*—* 






o 2 












CO 














































'O 














in 


















CO 




Zco 












c 




(0 










>, 










10 
























3 




<l> 










00 
















CO 


















O 














g 










a 






& 


c 

ho 


co 

C 


CO 

-a Z 




State 


CO 

z, 

< 


CO 

S 

o 

O 


CO 
.0 

u 


O 

o 

bo 
c 

■s 

cc 


CO 

■u 

(D 
N 
CO 


'5 

X 

tu- 
be 

c 

!2 


10 

CO 

3 


co 
cd 

0) 

f- 
< 

0) 




CO 

. 1- 
O 

L. 

o 

o 


o 
o 
Q 

•8 

CO 

J- 
O 
O 

Q 


to 

c_ 

o 

03 

> 

u 


10 

0> 

o 

c 

03 

t_ 
.-> 

C 

w 


to 

1~ 

o 

o 


V. 

E 
a 

at 


c 

03 

s 

1 

10 

(— 

'3 
to 




CO 

O 

i_ 
■*-> 

c 
o 

o 


to 

■S3 

io 

br 
C 

c 

t. 
3. 

5 


to 

■a 

in 
bo 

_c 

'E 

1- 
CD 


CO 

c 

3 
C 

u, 

0) 

*-* 
CO 


.o < 

u 

to o> 
CO T3 

S3 

< .E 




Ohio 


























X 




X 












X 




Mentions 
onlv 


Oklahoma 


+ * 












































"Except 
elevators" 


Oregon 


+# 












































"Full con- 
sideration to 
ANSI 


Pennsylvania 


+ 








X 


X 


X 








X 


X 


X 


X 


X 


X 




X 






X 






Rhode Island 


X 






X 


X 


X 


X 








X 


X 


X 


X 


X 


X 




X 


X 


X 


X 






S . Carolina 


+ 










































X 


"Full con- 
sideration to 

ANSI 


S. Dakota 


+# 














































Tennessee 


# 


X 






X 










X 












X 












X 


+Fire escapes 
<5c escalators 


Texas 


X 






X 


X 


X 


X 








X 


X 


X 


X 


X 


X 




X 


X 


X 


X 






Utah 


+# 














































Vermont 


X 










X 


















X 


















Virginia 


+# 














































Washington 


IT 










































X 




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Key: * In part 

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+ Stated in 1973 Legislative Survey by President's Committee on 
Employment of the Handicapped. 



120 



(4) Many of the statutes were not found directly under an architectural barriers 
heading, but were given under such headings as highway, traffic, pedestrian, white 
cane, or civil rights. 

Many of these did not appear to contain cross-referencing. With the help of private 
organizations, the Council of State Governments, and the National Center for Law and 
the Handicapped, Inc., the states may be able to modify and cross-reference their laws 
and regulations to bring about greater uniformity. 

construction codes and standards 

Standards comprise those specifications and methods that have been formally adopted 
by an organization. Standards are recipes for some degree of success in an area. They 
become mandatory when referenced or quoted in a law and the word "shall" denotes 
requirement. The terms "codes" and "standards" are often interchanged. 

Construction codes or standards and related ordinances are documents developed to 
protect citizens from the consequences of dangerous building practices. Typical major 
codes and ordinances are related to building, plumbing, electrical work, fire prevention, 
housing, heating and air conditioning, zoning, and sub division regulations. Local and 
state governments adopt and enforce these regulations for safety and for protection of 
public health and the general welfare through minimum requirements for construction 
or modification of buildings. These codes define the minimum standards of safety 
required for design professionals, for contractors, for citizens, and for the community in 
general. 

Among the model codes used are 

(1) The Standard Building Code (SBCC); 

(2) National Building Code (NBC); 

(3) Basic Building Code produced by the Building Officials and Code Administrators 
International, Inc. (BOCA); 

(4) National Fire Protection Association (NFPA), which produces the fire code and 
also National Electrical Code— NFPA 70-1975; and 

(5) Uniform Building Code— put out by the International Conference of Buildings 
Officials (ICBO). 

The Council of American Building Officials (CABO), made up of Standard Building Code 
Council, International Conference of Buildings Officials and Building Officials and Code 
Administrators, is instituting some coordinating efforts among some of the model codes 
to solve problems. Many groups use these codes because they offer a uniform approach, 
especially to the smaller community; they allow use of new materials while providing 
reasonable safeguards; and they are easy to maintain and update. Occasionally a 

121 



smaller community will develop its own code, but most adopt one or more of those 
listed above. Many cities have specialized needs, and the funds and personnel to 
develop their own standards in a local building code. 

Standards are developed by the combined efforts, experience and abilities of many 
technical committees representing producers and consumers. The committees work out 
and agree upon the details of various specifications and methods and make recommen- 
dations to the organization. This allows opportunity for all concerned to express views 
and reach agreement. When approved by members, the methods and specifications 
carry full support of the organization. The most important standards with regard to 
barrier-free design are included in the American National Standards Institute Standard 
Specifications. 

American National Standards Institute Standard Specifications for Making Buildings and 
Facilities Accessible to and Usable by the Physically Handicapped, (American National 
Standards Institute Standard Specifications) A117. 1-1961. ANSI— American National 
Standards Institute— is a standards "library." American National Standards Institute is a 
consensus organization, like some other such groups, which promulgate standards. 
These specifications regarding barrier-free design, include Scope and Purpose, defini- 
tions, General Principles and Considerations, Site Development and Buildings. Some are 
specific and many are general in nature. They do not include specifications for 
sidewalks, crosswalks or streets. They do not include reference to specific regulations 
which would apply to various specific types of areas such as terminals and stations. 
Therefore, each Federal department, as well as others, has felt the need to supplement 
or amplify these standards. 

Mr. W.A. Nelsen, acting Commissioner, Public Building Service, GSA, states: 

That Standard has not been updated since its preparation in 1961. Social, 
psychological and technological changes have caused many more handicapped 
persons to become more mobile. The original American National Standards 
Institute Specifications A117.1 contributed to this change but it no longer 
satisfied the needs of today's more mobile handicapped. Accessibility— The Law 
and the Reality, A Survey to Test the Application and Effectiveness of Public Law 
90-480 in Iowa , lists problems and suggested solutions. 

In recognition of the fact, General Services Administration and.. .Housing and 
Urban Development have separately contracted for the development of new 
standards to better implement their respective responsibilities under Public Law 
90-480. Until.. .completed, we have recommended to all... regional commissions 
that the Handicapped Section of the North Carolina State Building Code be 
applied in new construction projects. 

An Illustrated „ Handbook of the Handicapped Section of the North Carolina State 
Building Code . This standard applies to all buildings and facilities regulated by the 
North Carolina State Building Code, with the exception of single and two-family 
detached dwellings, small buildings already built, and historic restoration. It is 
mandatory in North Carolina. It encompasses the American National Standards 

122 



Institute Standard Specifications but expands on some and adds others, and is well 
illustrated. It includes curb ramping, walks and parking lots, and a great deal about site 
development. It does not contain specifics on sidewalks, cross-walks or streets and 
intersections. It is one of the best codes available today in the United States. 

No one set of standards, like no one definition, seems likely to address all problems. 
But one set of standards can act as the base and serve as a general guideline for others. 
American National Standards Institute Standard Specifications have been used in this 
manner in the past. They were widely followed both in federal and state statutes. 
However, these standards have been widely supplemented by necessity because they no 
longer fulfill all general or specific needs. For these reasons Syracuse University has 
been awarded a contract by the Department of Housing and Urban Development to 
prepare revisions and additions to the American National Standards Institute Standard 
Specifications and to bring them up to the state-of-the-art, preparatory to submitting 
them to the American National Standards Institute. They will be submitted to certain 
individuals for comment, and to any citizen requesting to do so, before final revision 
and acceptance. The Advisory Panel includes designers, builders, industry people and 
consumers. It may take some time for rewriting and approval of the new, and much 
needed standards. 

the private sector 

Many private organizations are working towards accessibility. A few examples will 
show the increasing interest and concern being shown by private citizens and businesses. 

The American Congress of Rehabilitation Medicine has appointed a committee on social 
aspects of rehabilitation to include an Architectural Barriers Task Force. Holiday Inns 
have made more than six hundred Inns accessible during the past nine years. Other such 
organizations include Disney World, McDonald Hamburgers, Hilton International, and 
Marriott Corporation. The Young Lawyers' section of the American Bar Association 
passed a resolution in 1976 supporting vigorous enforcement of barrier-free design laws. 
Sears did a survey of costs of accessibility and found that reasonable accommodation is 
"not expensive at all" for a company of their size and they practice it. Kaiser intends 
to revamp its twenty-seven story headquarters to facilitate disabled workers. The 
National Council for Interior Design is including questions on barrier-free design in its 
examination. The Container Corporation of America has moved to a new accessible 
plant. K-Mart Stores are accessible, including one check-out line in each store. Trans- 
World Airlines has published a brochure on services, safety aspects and policies for 
handicapped travelers. Several sections of the American Society of Civil Engineers 
have endorsed the National Policy for a Barrier-Free Environment. The National 
Association of Student Councils passed a resolution to strike down barriers in their 
localities. Many people are concerned and working toward accessibility. Many of these 
belong to an organization called the National Center for Barrier-Free Environment. 

These are only a few of the myriad examples of private enterprise in action for barrier- 
free design. 



123 



definitions used in laws, regulations, 
standards and resource papers 

Introduction Summary of Definitions 

Early references to elderly and handicapped people were brief and limited. Most 
emphasis was placed on a job handicap and the ability to work or be returned to 
employment. Later, vocational rehabilitation was identified as a national and cultural 
economic necessity in a healthy society and mental disability also began to be 
emphasized. Only in the past few years has an attempt been made to deal with 
definitions of what constitutes a disability, by specifying problems such as cancer, 
amputation, cystic fibrosis, hemiplegia and mental illness, or deficits in ambulation, 
sight and hearing, and coordination, etc. Later definitions also include disabilities of 
aging as well as hidden and temporary disability problems. 

The most recent legislation places emphasis on independent living and impairment to 
major life activities. There has also been a growing tendency to define disabilities on a 
functional level continuum along with developing clearer definitions of the words 
"handicap," "disability," and "impairment". 

Definitions Used in Laws, Regulations, Standards and Resource Papers (see Table 19). 

References to handicapped or elderly in early laws in the United States were brief and 
limited. In 1917 and 1918, Minnesota and Massachusetts passed laws to include 
vocational rehabilitation for "persons disabled in industry and otherwise." Other early 
definitions for vocational rehabilitation include: 

Skills and actions needed to remove the barriers that separate the disabled person 
from employment are the skills and actions of vocational rehabilitation. 

Rehabilitation may be understood to be that activity that is required to assist an 
individual to move from a status of inadequacy to a status of adequacy. 

Rehabilitation shall be construed to mean the rendering of a disabled person fit to 
engage in remunerative occupation. 

The Rehabilitation Act of 1920 promoted "...vocational rehabilitation of persons 
disabled in industry and service." 

By 1941, vocational rehabilitation became "... the rendering of a disabled individual fit 
to engage in remunerative occupation and his placement in employment, including, 
where needed, physical restoration and repair, medical examination and care, prosthetic 
and other devices, physical and occupational therapy, training, placement in employ- 
ment and other appropriate services." 

By 1943, it was felt that disability was not a handicap to production and employment 
and that vocational rehabilitation had "...become a rational and cultural-economic 
necessity in a healthy society." 

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126 



By 1948, vocational rehabilitation for civilians included: "All men and women of 
working age with substantial job handicaps in the form of physical or mental 
impairments.... The services are not only for those where disabilities are readily seen 
such as amputees, paraplegics, spastics, smd the visually impaired, but also those with 
unseen handicaps such as tuberculosis, ejmotional disabilities, arthritis, deafness, and 
heart disease." 

During this same period, the elderly w€;re beginning to receive recognition. The Social 
Security Act of 1935 included "Old Age Assistance and Old Age Survivor's Insurance." 

By 1954, the Vocational Rehabilitation Amendments used the term "physically 
handicapped individual" to mean "any individual who is under a physical or mental 
disability which constitutes a substantial handicap to employment, but which is of such 
a nature that vocational rehabilitation services may reasonably be expected to render 
him fit to engage in a remunerative occupation." 

In 1961, The American National Standard Specifications for Making Buildings and 
Facilities Accessible to and Usable by the Physically Handicapped had been adopted by 
the ASA. The definitions section contained very specific references to many types of 
handicaps not included before, and contained "aging" as one category. The definitions 
read: 

2.1 Non-ambulatory Disabilities . Impairments that, regardless of cause or manifes- 
tation, for all practical purposes, confine individuals to wheelchairs. 

2.2 Semi-ambulatory Disabilities . Impairments that cause individuals to walk with 
difficulty or insecurity. Indivi duals using braces or crutches, amputees, arthritics, 
spastics, and those with pulmonary and cardiac ills may be semi-ambulatory. 

2.3 Sight Disabilities . Total blindness or impairments affecting sight to the extent 
that the individual functioning in public areas is insecure or exposed to danger. 

2.4 Hearing Disabilities . Deafness or hearing handicaps that might make an individual 
insecure in public areas because he is unable to communicate or hear warning 
signals. 

2.5 Disabilities of Incoordinatio n. Faulty coordination or palsy from brain, spinal or 
peripheral nerve injury. 

2.6 Aging . Those manifestations of the aging process that significantly reduce 
mobility, flexibility, coordination, and perceptiveness but are not accounted for in 
the aforementioned categories. 

2.10 Involved (Involvement) . A portion or portions of the human anatomy or 
physiology, or both, that have a loss or impairment of normal function as a result 
of genesis, trauma, disease, inflammation or degeneration. 

An added description reads: "Note: Disabilities are specific and where the individual 
has been properly evaluated and properly oriented and where architectural barriers have 

127 



been eliminated, a specific disability does noit constitute a handicap. It should be 
emphasized that more and more of those physically disabled are becoming participants , 
rather than spectators in the fullest meaning of the word." 

The Vocational Rehabilitation Act as amended through 1965, Public Law 89-333 , states: 
"The term 'handicapped individual' means any individual who is under a physical or 
mental disability which constitutes a substantial handicap to employment, but which is 
of such a nature that vocational rehabilitation services may reasonably be expected to 
render him fit to engage in gainful occupation ../individual who is under a physical or 
mental disability' means an individual who has a physical or mental condition which 
materially limits, contributes to limiting, or, if not corrected, will probably result in 
limiting his activities or functioning." According to the Fact Sheet put out by the 
Department of Health, Education and Welfare soon after passage of the Act, the entire 
Act "is amended in several places to delete the term 'physically handicapped' and 
substitute the term 'handicapped.' This is done to simplify terminology and to avoid the 
inference that the program is not concerned with persons with mental handicaps." 

Some states were making great strides in developing criteria. The State University 
Construction Fund of New York in its widely distributed publication, Making Facilities 
Accessible to the Physically Handicapped , states that "in planning, two main types of 
handicapped are to be considered: 

(1) The ambulant and semi-ambulant— including persons with crutches or walking 
sticks, the visually impaired, individuals with cardiac conditions, and the deaf; 

(2) Paraplegics, amputees and hemiplegics—all of whom are handicapped in the upper 
or lower extremities to an extent which usually dictates their confinement to a 
wheelchair." 

Massachusetts passed a law in 1968 which stated the it the definition of "physically 
handicapped" used in that legislation is "a person conf ined to a wheelchair; a person 
who, because of the use of braces or crutches or because of a loss of a foot or leg or 
because of an arthritis, spastic, pulmonary or cardiac con dition, walks with difficulty or 
insecurity; a person who, due to a brain, spinal, or peripheral nerve injury, suffers from 
a faulty coordination or palsy; a person who is blind or w,hose sight is so impaired that, 
functioning in a public area, is insecure or exposed to danger; a person whose hearing is 
so impaired that he is unable to hear warning signals; and a person whose mobility, 
flexibility, coordination and perceptiveness are significant! ly reduced by aging." 

43 
The "Architectural Barriers Act" passed in 1968, states that it is to be concerned with 

"physically handicapped persons" and the "physically handicapped." However, the Act 

itself does not define that term. 

75 
The Department of Transportation put out a booklet called Travel Barriers in May of 

1970. It was a report summarizing the findings of the Department of Transportation 

sponsored research program. It stated that handicapped travelers included the aged, 

those with chronic medical conditions, short-term illness or injury, those who are 

oversize or undersize, pregnant, blind or with impaired senses, and also those carrying 

bulky packages or suitcases and children. 

128 



In 1971, during the hearings on A Barrier-Free Environment for the Elderly and the 
Handicapped, on October 18, 1971, before the Senate Special Subcommittee on Aging, 
Peter Lassen described handicapped persons as including paraplegics, visually impaired, 
aged, cardiacs, etc., and also including less obvious groups such as pregnant women, 
mothers with babies, persons carrying heavy packages, temporary disabilities such as 
broken bones, invisible disabilities such as respiratory difficulties, etc. He observed 
that it could be said that handicapped people could include, but not be limited to, people 
in wheelchairs, visually impaired, amputees, mentally sub-normal and all others and thus 
not leave anyone out that might have such a classification. During that same hearing, 
Cecelia 0. Neill stated that if the design criteria were based on access of the elderly in 
wheelchairs, that all other groups would be covered as well. In subsequent legislation 
and in both the research on "Travel Barriers" and the Hearings by the Special 
Subcommittee on the Aging, Mrs. Kathaleen Arneson and Dr. William Bean of the 
Rehabilitation Services Administration provided the basic orientation and historical 
perspective on federal governmental efforts including barriers as well as definitions. 

At about the same time, other definitions were attempted. Public Law 91-230 , Title VI 
as amended, stated that, in education, "'handicapped' refers to mental retardation, hard 
of hearing, deaf, speech impaired, visually handicapped, seriously emotionally disturbed, 
crippled, or other health-impaired and learning-disabled children, who, by reason 
thereof, require special education and related services." 

Public Law 91-517 states that in the Developmental Disabilities Program "...'develop- 
mental disability' refers to a disability attributed to mental retardation, cerebral palsy, 
epilepsy, or another nervous condition, closely related to mental retardation," which 
originated before age 19, and can be expected to continue indefinitely and constitute 
substantial handicap to such individuals. 

Social Security programs state that disability refers to an "inability to engage in any 
substantial gainful activity by reason of any medically determinable physical or mental 
impairment which can be expected to last for a continuous period of not less than 
twelve months." 

The Urban Mass Transportation Act of 1964 , Public Law 91-453, as amended in 1974, 
defines, "For purposes of this Act, the term 'handicapped person' means any individual 
who, by reason of illness, injury, age, congenital malfunction, or other permanent or 
temporary incapacity or disability, is unable without special facilities or special 
planning or design to utilize mass transportation facilities and services as effectively as 
persons who are not so affected." 

Section 105(b) of the Federal-Aid Highway Act Amendments of 1974 , Public Law 93- 
643 amends the above definition by inserting after "disability" and before "are unable" 
the words "including those who are non-ambulatory, wheelchair bound and those with 
semi-ambulatory capabilities," and completes the sentence as "to utilize such facilities 
and services effectively." 



129 



48 

The Rehabilitation Act of 1973 , Public Law 93-112, ° states that: 

(1) The term "handicapped individual" means any individual who (a) has a physical or 
mental disability which for such individual constitutes or results in a substantial 
handicap to employment and (b) can reasonably be expected to benefit in terms of 
employability from vocational rehabilitation services provided pursuant to Titles I 
and III of this Act. 

(2) The term "severely handicapped" means the disability which requires multiple 
services over an extended period of time and results from amputation, blindness, 
cancer, cerebral palsy, cystic fibrosis, deafness, heart disease, hemiplegia, mental 
retardation, mental illness, multiple sclerosis, muscular distrophy, neurological 
disorders (including stroke and epilepsy) paraplegia, quadriplegia and other spinal 
cord conditions, renal failure, respiratory or pulmonary dysfunction, and any other 
disability specified by the Secretary in regulations he shall prescribe. 

Thus, the Act requires that the Department of Health, Education and Welfare and State 
Vocational rehabilitation agencies provide services on a priority basis to "those with the 
most severe handicaps, so that they may prepare for and engage in gainful 
employment." 

The basic condition of elegibility according to the manual of politics, Georgia Division 
of Vocational Rehabilitation Service, March, 1974, shall be based upon: 

(1) The presence of a physical and/or mental impairment; 

(2) The existence of a substantial handicap to employment (a physical or mental 
disability) which in the light of attendant medical, psychological, vocational, 
educational, cultural, social or environmental factors impedes an individual's 
occupational performance by preventing his obtaining, retaining or preparing for a 
gainful occupation consistent with his capacities and abilities; 

(3) A reasonable expectation that vocational rehabilitation services will render the 
individual fit to engage in a gainful occupation (including employment in a 
competitive labor market; practice of a profession; self-employment; farm or 
family, including work for which payments are in kind rather than in cash; 
sheltered employment; and home industries or other gainful homebound work). 

Perhaps the most significant change in definition is the change of title from the 
Vocational Rehabilitation Act to the Rehabilitation Act. 

50 
Section 111(a) of the Rehabilitation Act Amendments of 1974 contains a new 

definition of a handicapped individual for use with Titles IV and V. These titles concern 
the responsibilities of the Secretary (Office for Handicapped Individuals) and Title V 
(Architectural Barriers, Employment of the Handicapped in Government, and Affirma- 
tive Action Employment Plan). The new definition is as follows: "Any person who (a) 
has a physical or mental impairment which substantially limits one or more of such 
person's major life activities; (b) has a record of such impairment, or (c) is regarded as 

130 



having such impairment." The definition of a handicapped individual as related to the 
provision of vocational rehabilitation services has not changed. 

The Rehabilitation Comprehensive Services and Developmental Disabilities Amend- 
ments of 1978 adds the following definition under Title V: 

"The term 'developmental disability 1 means a severe, chronic disability of a person 
which: 

(A) is attributable to a mental or physical impairment or combination of mental 
and physical impairments; 

(B) is manifested before the person attains age twenty-two; 

(C) is likely to continue indefinitely; 

(D) results in substantial functional limitations in three or more of the following 
areas of major life activity: (i) self-care, (ii) receptive and expressive 
language, (iii) learning, (iv) mobility, (v) self-direction, (vi) capacity for 
independent living, and (vii) economic self-sufficiency; and 

(E) reflects the person's need for a combination and sequence of special, 
interdisciplinary, or generic care, treatment, or other services which are of 
lifelong or extended duration and are individually planned and coordinated." 

Under Title VII, services may be provided to individuals with impairment so severe as to 
require appreciably more costly rehabilitation services than are normally required in 
order to improve significantly the ability to be employed or to function independently in 
the family or community. 

64 

The Housing and Community Development Act of 1974 broadens the definition of the 
term "handicapped" to cover specifically the mentally and physically handicapped, 
including the developmentally disabled. Community development programs to be 
assisted by the funds provided under this Act included special projects to remove 
material and architectural barriers which restrict mobility and accessibility of elderly 
and handicapped persons. 

The Department of Health, Education and Welfare Regulations of 1974 add "Temporary 
disabilities due to broken limbs, sprains, illness, pregnancy, etc." "Mental retardation" 
is mentioned as a group in which many would have physical disabilities that might 
benefit from "barrier-free design." 

In 1961, the first White House Conference on Aging was held. In response, The Older 
American Act of 1965 established the Administration on Aging. In 1971, the Second 
White House Conference on Aging was held. In the first report of this Conference, 
those 55 and over, even though disabled, were felt to be contributors, if suitably 
rehabilitated and provided employment opportunities. In one place in the report, aged 
were described as over 75. 

131 



The Older Americans Act of 1965 provided the most concrete incentive for concerted 
federal and state programs to remedy the problems of the aged, including "...the best 
possible physical and mental health; suitable housing; full restorative service...." 

The Social Security Amendments that same year established Medicare. 

The Older Americans Act of 1965 as Amended in 1973, Public Law 93-29 , made 
reference to adapting housing to older persons suffering from physical disabilities; 
providing services to assist in meeting particular needs of physically and mentally 
impaired older persons, to assist them to lead more independent lives; and provision of 
multipurpose senior centers constructed in compliance with the "Architectural Barriers 
Law." 

The Urban Mass Transportation Act of 1964 , as amended defines a handicapped person 
as "any individual who by reason of illness, injury, age, congenital malfunction or other 
impairment or temporary incapacity or disability..." is unable to fully utilize services. 
A similar definition is found in the Federal Aid Highway Act of 1973 , as amended. 

The regulations under Section 503 and Section 504 of the Rehabilitation Act of 1973 
reference the need to remove barriers to provide reasonable accommodation to the 
needs of disabled people for an accessible and usable environment in which to study, 
work, play and generally live productive lives. 

The White House Conference on Handicapped Individuals of 1977 studied definitions 
along with many other problems facing this group. Their definitions will have an impact 
on many problems facing handicapped individuals and clarification of terms is sure to be 
among them. 

Currently, there is a growing tendency to define disabilities on a functional continuum 
along with developing clearer definitions of the words "handicap", "disability", and 
"impairment". 

summary, conclusions, and recommendations 

Federal Laws . Many laws directed at helping elderly and handicapped people have been 
passed in this century. The most active period has been during the past two decades. 
Since the acceptance of the American National Standards Institute Standard Specifica- 
tions in 1961, several significant laws have contained reference to the needs and rights 
of elderly and handicapped citizens. Such laws include the Vocational Rehabilitation 
Act Amendments of 1965, the "Architectural Barriers Act" of 1968 as amended, the 
Urban Mass Transportation Assistance Act of 1964 as amended, the Federal-Aid 
Highway Act of 1973 as amended, the Rehabilitation Act of 1973, as amended, the Tax 
Reform Act of 1976, and to a certain extent, the Older Americans Act of 1965 as 
amended. The need now is to coordinate the implementation of these statutes. 

Early in this century, as befitted the work ethic of our society, only those physically 
handicapped individuals who were potentially employable were considered as heeding 

132 



special care. In the 1940's and 1950's, it was not only an "economic necessity" but 
"rational" in a "healthy society to rehabilitate the handicapped for employment." Later, 
mental impairments along with "unseen handicaps" became a concern. By 1961 the 
ANSI Standard Specifications contained specific reference to non-ambulatory, semi- 
ambulatory, sight, hearing, incoordination disabilities and aging. More and more, 
"disability" was thought of as the impairment, and "handicap" as the inability to do 
certain things because of the effect of the impairment. Later the word "physically" was 
dropped as a modifier to "handicapped" and "vocational" was dropped from "rehabilita- 
tion." 

Most recently, temporary disabilities and oversize and undersize were added to the 
longer lists found in various laws and statements of specific disabilities that had taken 
the place of generic term "handicaps." By 1974, Federal Law included any person "who 
has a physical or mental impairment which substantially limits one or more of such 
person's major life activities." Thus, the emphasis included not only economics but 
social mainstream ing. The preceding definitions are appropriate but not without 
ambiguity and confusion and are in need of clarification and coordination. 

78 
As stated in the Congressional Record , No. 107, Vol. 120, July 18, 1974, the 

Subcommittee on the Handicapped, during consideration of the Rehabilitation Act of 

1973, found that compliance with the major Federal law on the subject of architectural 

barriers (Public Law 90-480) had faltered because of unclear compliance procedures and 

administration responsibility. The Rehabilitation Act Amendments of 1974 improved 

this situation somewhat, and only after a period of appropriate application will it be 

known if improvement is adequate. 

One of the most important areas in which change is needed is in Federal Regulations . 
Most major Federal regulations reflect the essence of the American National Standards 
Institute Standard Specifications, with some additions or exceptions in some areas. The 
American National Standards Institute Standard Specifications are being updated and 
expanded in scope to cover more categories more completely. Such revision is badly 
needed. 

In looking through the supplemental regulations or standard for each federal 
department, it is apparent that there has been an attempt to augment or modify the 
American National Standards Institute Standard Specifications to meet specific need& 
The best known attempt is the Federal Property Management Regulations (FPMR). 
Many of these additional standards are not clearly delineated or defined and often are 
not printed in one place in the regulations. Also, each department has individual 
problems to solve, many of them "new" and untested. Few of the regulations and 
standards include statements concerning handicapped and elderly pedestrians. Regula- 
tions involving streets, sidewalks, bus stops, and so forth are poor or lacking. 

As a rule, regulations do not give proper reference to all other applicable standards or 
regulations. Often, too, it is difficult to find the appropriate person or office 
responsible for developing the standards and/or the office from which to gather the 
information. 



133 



Until recently the standards and regulations have not been effective in eliminating 
architectural barriers as well as might have been expected considering the laws passed. 
In addition, agencies have not been Cooperating well enough to eliminate duplication, 
overlapping, and apparent non-compliance. It would seem that greater priority for such 
activity would bring greater results. The passage of Section 504 should result in 
reducing the deficiencies. 

Some form of organization of standards should be sought with a central source created 
for compliance and updating. No one rule or standard will apply to all circumstances, so 
interagency cooperation, communication and education need to be increased. 

The Architectural and Transportation Barriers Compliance Board, made up of the nine 
major federal agencies involved in the area, may be a good organization to unify all 
efforts and thereby make possible the creation of standard specifications with 
supplements to meet specific needs. Adequate enforcement powers will be needed to 
coordinate regulations between departments. 

Codes . A July, 1974 study done by the Atlanta Regional Commission (ARC) on 
Construction Codes in the Atlanta Area, A Survey of Current Practices stated that 
those interviewed felt that adoption of uniform construction codes brought trust 
between the community, builders and buyer; reduction in building costs; acceptance of 
new materials and techniques for construction; and improvement of the community's 
environment. The Commission recommends a regional training Center for Inspectors 
and adoption of a national or state model code for those communities that do not have 
codes, or that communities should contract such service with their county government. 
The Commission further recommends that a comprehensive code enforcement program 
should be one objective of every government. 

The Commission's report was deficient in that it did not include recommendations on 
the removal of architectural barriers standards. It would seem that this trust in the 
codes and what they can do should be carried one step further. Architectural barriers 
standards should be added to all of the codes, and clearly identified as such, so that they 
may be incorporated in spirit and in fact. Education must go hand-in-hand with the use 
of any such new code provisions. 

State Laws . Fifty states now appear to have some form of architectural barriers law. 
A survey of state architectural barriers laws showed that nearly all follow American 
National Standards Institute Standard Specifications in part or in toto (see Table 17). 
Most do not seem to have real "teeth" in their enforcement; only six have sanctions in 
the form of misdemeanors. Few of the state laws cross-reference the codes/standards 
used or recommended except in the case of the American National Standards Institute 
Standard Specifications. As with Federal regulations, these laws often do not 
encompass streets, crosswalks, intersections or sidewalks, nor were these found under 
traffic or motor vehicle regulations in six sample states checked. State laws also often 
do not include special facilities such as stations, terminals, bus stops, etc. 

Many statutes and regulations are so vague as to be difficult to follow and, as there are 
few states which demand compliance, there is little incentive to comply. The scope of 

134 



the laws is limited, for the most part, to public buildings only. Definitions of 
handicapped people are vague or not inclusive enough to reach most categories, and 
definitions of buildings and facilities are often not given. Very few require that the 
access symbol be displayed. All those loopholes should be remedied. 

Since all past references to the American National Standards Institute Standard 
Specifications refer to the A117. 1-1961 document, and since the newly proposed 
standards are more all-encompassing, it may be that there will be problems in achieving 
full adoption by Federal agencies in a reasonable time. States will have to amend old 
laws to include the new standards when they are adopted. 

There are many obstacles from the time a state (or Federal) bill is introduced until it is 
passed. The success in the states shows what can be accomplished with concerned 
effort and what must be done again to improve state laws. Several states have recently 
passed more appropriate laws and one state now has a compliance board. 

Improved laws and regulations, coupled with the education of those who will carry out 
the laws (state and local officials, architects, contractors, code officials) will result in 
improved service to handicapped and elderly people. 

summary of recommendations 

Consistency in Federal laws through coordination of writing and implementation of 
regulations in both requirements and definitions should be a primary goal. The best of 
the state laws should be used as models to develop more consistent and unified 
requirements for state laws. Codes should be studied by individuals and agencies using 
them and by the coding agencies to best utilize available expertise and to encourage 
consistency in these documents and their application. Laws must be enforced 
consistently, but interpretations should be flexible. Applications of the regulations 
should be made by knowledgable people who can assess how to best solve individual 
problems in a broad range of settings and situations. Most important, attitudinal 
barriers should be broken down through education and just application of all laws, 
regulations and codes. 

Some specific recommendations follow. 

1. Greater compliance with the "Architectural Barriers Act of 1968" as amended and 
the Rehabilitation Act of 1973 as amended and other appropriate laws through: 

a. Closing loopholes discovered in the laws when implementation is attempted. 

b. Increased, reporting to responsible agencies as well as Congress. 

c. Providing appropriate funding and support for the Architectural and Transpor- 
tation Barriers Compliance Board to unify and coordinate efforts and for 
compliance surveys as ascertained from the Board staff. 

d. Instituting stronger sanctions for non-compliance with the laws as needed. 

135 



e. Educating of lawmakers as to how to construct appropriate legislation. To 
meet needs of the handicapped by handicapped consumers and providers. 

f . Consistent application of laws through regulations. 

2. Encouragement of cooperation between states to coordinate their laws based on 
model laws and regulations to provide for greater consistency and cost 
effectiveness. 

3. Improvement in regulations and code and design standards through: 

• a. Periodic and regular updating of the basic American National Standard 
Specifications for making buildings and facilities accessible to, and usable by, 
the physically handicapped , 117.1 - 1961, R. 1971 (now underway) and their 
subsequent inclusion and enforcement. 

b. Updating the supplemental standards, based on the new ANSI Standards. 

c. Improving identification, codification and cross-referencing of all standards 
and regulations with clear reference as to what regulations and standards apply 
and where to find them. 

d. Removing ambiguity, confusion, and vagueness of regulations and standards. 

e. Aiding states to enact appropriate laws and regulations based on good model 
laws, such as the North Carolina Code, and the revised ANSI Standard No. 
117.1. 

f. Cooperation between those who are attempting to update standards and codes 
on all levels (i.e., Department HEW, ANSI, DOT-FH-1 1-8504, Illinois, North 
Carolina). 

g. Backing efforts of expert private groups that seek constructive change, (i.e., 
National Center for a Barrier-Free Environment, designers, and professionals 
in rehabilitation). 

h. Increasing educational efforts, including funding to support such efforts, for 
those using the standards and regulations. 

4. Improvement of definitions by: 

a. Updating the basic American National Standards Institute definitions (now 
being done). 

b. Updating and coordinating supplemental definitions to meet specific needs. 

c. Using functional rather than catagorical definitions. 

d. Clarifying the terms: "impairment," "disability", "handicap". 

136 



e. Updating of information and education and materials as a continuous, dynamic 
process to stay in line with needs and to sensitize new generations of people 
dealing with this process. 

5. Encouraging planning for retrofitting an existing environment to make it 
accessible through legislation and funding. 

6. Special efforts to make accessible streets, sidewalks, parks, public spaces and 
other facilities controlled by cities and local .authorities through inclusion in laws 
and standards (which this present research is addressing). 

7. Funding research for improvements in barrier-free design. 



137 




HHi 



1. Accident Facts, National Safety Comncil, Chicago, Illinois, 1974. 

2. Roed, O.J., "San Diego's Senior Citizen Pedestrian Safety Program," Traffic 
Digest and Review , Northwestern University Traffic Institute, August, 1971, pp. 

* 14-15. 

3. Baker, S.P., Robertson, L.S., and O'Neill, B., "Fatal Pedestrian Collisions; Driver 
Negligence," American Journal of Public Health , April, 1974, pp. 318-325. 

4. Hurley, J.L. & Thompson, R.L., Model Programs in Pedestrian and Bicycle Safety 
for Wisconsin Communities , University of Wisconsin, Whitewater, Department of 
Safety Education, January, 1.973. 

5. Jones, T.O., Repa, B.S., and Potgiesiser, J.L., "A General Overview of Pedestrian 
Accidents and Protection Countermeasures," Proceedings, Third International 
Congress on Automotive Safety , Volume I, 1974. ~ 

6. Kuzimoko, L., Pedestrian Accident Study , New York State Department of Motor 
Vehicles, August, 1971. 

7. Mackie, A.M. & Older, S.J., "Study of Pedestrian Risk in Crossing Busy Roads in 
London Inner Suburbs," T 'raffic Engineering and Control , October, 1965, pp. 376- 
379. 

8. Pedestrian Protection , (A pamphlet), published by the Division of Highway Safety, 
Officer of the Governor, State of Wisconsin, 1974. 

9. Roberts, Diane C, "Pedestrian Needs: Insights from a Pilot Survey of Blind and 
Deaf Individuals," Highway Research Record , Number 403, Highway Research 
Board, 1972, pp. 51-52. 

10. Wiener, Earl L., Elderly Pedestrians and Drivers: The Problem that Refuses to Go 
Away , Miami University, Fl'.orida, 1972. 

11. Blackman, Allan, The Role of City Planning in Child Pedestrian Safety , Center for 
Planning and Researc h Development, July, 1966. 

12. Marsden, William E.., Jr., A Decade of Pedestrians and their Traffic Collisions 
(1963-1972) , Calif on nia State University, San Diego, August, 1973. 

13. Tharp, K.J., Multi disciplinary Accident Investigation— Pedestrian Involvement , 
Final Report, Natio nal Highway Traffic Safety Administration, June 1974. 

14. Fruin, John J., "Pedways versus Highways: The Pedestrian's Right to Urban 
Space," Highway Research Record , Number 406, Highway Research Board, 1972, 
pp. 28-36. 



138 



15. American Automobile Association: "The Young Pedestrian," Pedestrian Safety 
Program Series, Number 3, 1965, as cited in Jones, Repa, & Potgiesser, "A 
General Overview of Pedestrian Accidents and Protection Countermeasures," 
Proceedings, Third International Congress on Automobile Safety , Volume I, 1974. 

16. Marks, Harold, "Child Pedestrian Safety: A Realistic Approach," Traffic 
Engineering , October, 1957. 

17. Carp, Francis M., "Pedestrian Transportation for Retired People," Highway 
Research Record , Number 356, Highway Research Board, 1971, pp. 105-118. 

18. Lashley, Glen T., "The Aging Pedestrian," Traffic Safety , National Safety Council, 
August, 1960, pp. 18-19. 

19. Libow, Leslie S., "Older People's Medical and Physiological Characteristics: Some 
Implications for Transportation," Transportation and Aging, Selected Issues , edited 
by J. Cantilli and June L. Shmelzer, U.S. Government Printing Office, 1970. 

20. "The Senior Citizen in Traffic," Traffic Safety , National Safety Council, August, 
1960, pp. 18-19. 

21. Herms, Bruce F., Pedestrian Crosswalk Study , City of San Diego, California, 1970, 
as cited in Marsden, A Decade of Pedestrians and Their Traffic Collisions (1963- 
1972), California State University, San Diego, August, 1973. 

22. Bruce, John, "One-Way Major Arterial Streets," Highway Research Board Special 
Report , Number 93, 1967. 

23. Fruin, John J., Pedestrian Planning and Design , Metropolitan Association of Urban 
Designers and Environmental Planners, Inc., 1971. 

24. Marsden, William E., Jr., Alcohol and Pedestrian Fatalities: A Study of Fatal 
Pedestrian Collisions in San Diego County , San Diego County, California, 
Engineering Department, 1972. 

25. Templer, J.A., Stair Slope and Human Movement , (unpublished doctoral disser- 
tation), Columbia University, New York, 1974. 

26. "Use of Special Aids" Vital and Health Statistics, National Center for Health 
Statistics, Series 10, No. 78, 1969. 

27. U.S. Summary: General Population Characteristics , Vol. 1, Pt. 1, Tables 50, 52 
and 53, U.S. Census, Washington, D.C., 1970. 

28. Vital and Health Statistics , DHEW Washington, D.C., Series 10, No. 78, 1969. 

29. "Impairments Due to Injury," Vital and Health Statistics, National Center for 
Health Statistics, Series 10, No. 87, 1971. 

139 



30. National Institute of Mental Health, Patients in Mental Institutions, II , 1964. 

31. Department of Health, Education and Welfare, Series 10, No. 46, "Characteristics 
of Visually Impaired Persons," U.S., July 1963-June 1964, Vital Health Statistics, 
National Center for Health Statistics. 

32. Hatfield, E.M., "Estimates of Blindness in the United States," The Sight-Saving 
Review, Vol. 43, No. 2, pp. 69-80, 1973. 

33. National Society for the Prevention of Blindness, Inc., Unpublished Report, 
January 1975. 

34. Mudford, H.A., "Drinking and Deviant Drinking, U.S.A., 1963," Quarterly Journal 
of Studies on Alcohol, Vol. 25, 1964. 

35. Eddy, Nathan; H. Halback: Ing. Harris Isbel and Maurice H. Seevers, Drug 
Dependence: Its Significance and Characteristics , Bulletin, WHO, Vol. 32, 1965. 

36. Martindale, Don and Edith Martindale, The Social Dimensions of Mental Illness, 
Alcoholism and Drug Dependence , Glenwood Publishing Co., 1973. 

37. U.S. Bureau of Census, Current Population Report Series P25, No. 311, 483 & 493. 

38. American National Standards Institute. 

39. American National Standards Institute, Inc., American National Standards 
Specifications for Making Buildings and Facilities Accessible to and Usable by the 
Physically Handicapped , A117.1, New York, ANSI, 1961. 

40. Nugent, Timothy J., "Design of Buildings to Permit Their Use by the Physically 
Handicapped," New Building Research , Fall, 1960, Publication 910, Buildings 
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41. Legislative Mandate of the Architectural and Transportation Barriers Compliance 
Board , 1977. 

42. General Services Administration, Federal Property Management Regulations , 
Subpart 101-19.6, "Accommodations for the Physically Handicapped." 

43. "Architectural Barriers Act," P.L. 90-480, An Act to Ensure that Certain Buildings 
Financed with Federal Funds are so Designed and Constructed as to be Accessible 
to the Physically Handicapped , 1968. 

44. "Design and Construction of Federal Facilities to be Accessible to the Physically 
Handicapped," Hearings before the Subcommittee on Public Buildings and Grounds 
of the Committee on Public Works, House of Representatives, 91st Congress, 1st 
Session on H.R. 14464, December 9, 1969. 

45. Washington Metropolitan Area Transit, P.L. 91-205 , March 5, 1970. 

140 



46. Amendments to Architectural Barriers Act, P.L. 90-541 , October 18, 1976. 

47. First Report of the Architectural and Transportation Barriers Compliance Board 
to the Congress of the United States, November, 1974. 

48. Rehabilitation Act of 1973, P.L. 93.112 . 

49. Affirmative Action, A Resource Manual For Vocational Rehabilitation , Third 
Institute on Rehabilitation Issues, Figure 1, June 1-3, 1976, Dallas, Texas. (See 
Table 16). 

50. Rehabilitation Act Amendments of 1974, P.L. 93-516 . 

51. 1977 White House Conference on Handicapped Individuals , Vol. I, n, HI, 1978. 

52. Rehabilitation, Comprehensive Services, and Developmental Disabilities Amend- 
ments of 1978, P.L. 95-602 (HR-12467X 

53. Executive Order 11914 , issued by President Gerald Ford, April 28, 1976. 

54. Final Rule , General Services Administration, April 19, 1978. 

55. Tax Reform Act of 1976, Tax Reduction for Removal of Architectural and 
Transportation Barriers, P.L. 94-455 . 

56. Urban Mass Transportation Assistance Act of 1964 as Amended in 1970, P.L. 91- 
453 . 

57. Federal-Aid Highway Act of 1973, P.L. 93-87 . 

58. Federal-Aid Highway Act Amendments of 1974, P.L. 93-643 . 

59. Department of Transportation and Rehabilitation Agencies Appropriation Act of 
1975, P.L. 93-391 . 

60. Urban Mass Transportation Act of 1964 as Amended by The National Mass 
Transportation Act of 1974, Public Law 93-503, Section 5(M). 

61. Older Americans Act of 1965 as Amended in 1973, P.L. 93-29 . 

62. Older Americans Act of 1965 as Amended in 1974, P.L. 93-351 . 

63. The Housing and Community Development Act of 1964, P.L. 88-560 . 

64. The Housing and Community Development Act of 1974, P.L. 93-383 . 

65. HEW News , Statement by Joseph A. Califano, Jr., Sec, April 28, 1977. 



141 



66. Department of Health, Education and Welfare, Technical Handbook for Facilities, 
Engineering & Construction Manual , Part 4, Facilities and Construction 4.00, 
Architectural Section 4.12, "Design of Barrier-Free Facilities," September, 1975. 

67. Department of Defense, Department of the Army, Design for the Physically 
Handicapped , EM1110-103, October 15, 1976. 

68. Office of Public Affairs, "Transbus Features," UMTA, 1977, News , May 19, 1977. 

69. "Transportation of the Elderly and Handicapped," Technology Sharing , January, 
1977. 

70. National Highway Traffic Safety Administration, Tips on Cars and Safety for Deaf 
Drivers , July, 1975. 

71. Federal Aviation Administration, "Air Transportation of Handicapped Persons," 
Advisory Circular , AC 120-32, March 25, 1977. 

72. Committee on Barrier-Free Design: The President's Committee on Employment 
of the Handicapped, A Survey of State Legislation to Remove Architectural 
Barriers , Washington, 1973. 

73. Mace, Ronald L., and Laslett, Betsy, Eds., An Illustrated Handbook of the 
Handicapped Section of the North Carolina State Building Code , 1974. 

74. Vocational Rehabilitation Administration, Fact Sheet on the Vocational Rehabili- 
tation Act Amendments of 1965 , P.L. 89-333, Washington, D.C. 

75. "Travel Barriers," Office of the Secretary, May, 1970. 

76. "A Barrier Free Environment for the Elderly and the Handicapped," Hearings 
before the Special Committee on Aging, U.S. Senate, 92nd Congress, First Session, 
Parts 2 and 3, October 19-20, 1971. 

77. Freedom of Choice , Report to the President and to The Congress on "Housing 
Needs of Handicapped Individuals," Washington, D.C, October, 1975. 

78. "Accessibility, the Law and Reality," 93rd Congress, 2nd Session, Senate, 120: No. 
107, Washington, D.C, July 18, 1974. 

79. U.S. Summary: General Population Characteristics , Vol. 1, Pt. 1, Table 56, p. 
282. 

80. U.S. Summary: General Population Characteristics , Vol. 1, Pt. 1, Table 52, p. 
269-274. 

81. "Characteristics of Persons with Impaired Hearing," Vital and Health Statistics, 
National Center for Health Statistics, Series 10, No. 35, U.S., July 1962-June 
1963. 

142 



82. Cisin, I.H., Paper presented before American Association for the Advancement of 
Science on the Characteristics of Drinkers, December, 1966. 

83. Efron, V., and M. Keller, Selected Statistical Tables on the Consumption of 
Alcohol, 1850-1962 , New Brunswick, N.J., Rutgers Center of Alcohol Studies, 
1963. 

84. Giese, Donald J., Report on Drinking , St. Paul Pioneer Press, May 25, 1969. 

85. Jellinek, E.M., The Disease Concept of Alcoholism , Hillhouse Press, 1960. 

86. Louria, Donald B., The Drug Scene , McGraw Hill. 

87. Alcoholism, 1930-1960 , New Brunswick, N.J., Rutgers Center of Alcohol Studies, 
1969. 

88. Szasz, Thomas S., The Myth of Mental Illness: Foundations of a Theory of 
Personal Conduct , Harper and Row. 

Additional References to Part 3 

Articles 

Council of State Governments, Architectural Barriers , Suggested State Legisla- 
tion, 1965. 

Dantona, Robert and Tessler, Benjamin, "Architectural Barriers for the Handi- 
capped: A Survey of the Law in the United States," Reprint from Rehabilitation 
Literature , 28: (February, 1967), 34-43. 

Fearn, Donald E., "Easier Entrance and Safer Use: Two Hospital Design Goals," 
Distributed as a reprint by the National Society for Crippled Children and Adults, 
Hospitals , 40, February 1, 1966. 

Finley, F., Ray and Cody, Kevin A., "Locomotive Characteristics of Urban 
Pedestrians," Archives of Physical Medicine and Rehabilitation , July, 1970. 

Jacobs, Eveline E., "Don't Let the Building Keep Them Away," International 
Journal of Religious Education . 

Jarler, Mildred, "Breaking those Barriers Down," Reprint, The Royer Forum , 
Spring, 1974. 

Jeffrey, Dorothy, "A Living Environment for the Physically Disabled," Reprint, 
Rehabilitation Literature , 34 (April, 1973), 90-103. 

Hillcary, James F., "Buildings for All to Use," Reprint, AIA Journal , March 1969. 

Laski, Frank, "Civil Rights Victories for the Handicapped I", The Record . 

143 



Latz, William F., "Let's Stop Constructing Inaccessible Buildings," Reprint, The 
Constructor , May, 1962. 

Mitra, S., "Some Disability Statistics of the United States Population," Paper 
prepared for Department of Transportation Contract No. DOT-FH-11-8504, 
"Provisions for Elderly and Handicapped Pedestrians," 1975. 

Palmer, J.D., Keith, M.D., Lynch, Robert J., and Tessler, Benjamin, "Architec- 
tural Barriers Legislation: An Assistive Device on a Large Scale," Southern 
Medicine (October, 1974), 22-27. 

President's Committee on Employment of the Handicapped and the National 
Society for Crippled Children and Adults, "Architectural Barriers and the 
Handicapped." 

President's Committee on Employment of the Handicapped, "Man-Made Barriers 
Limit the Mobility of the Handicapped," Reprint, Journal of American Insurance , 
Spring, 1974. 

Rehabilitation Council, United Comm. Services, Board of Directors, Boston, 
Mass., "Architectural Barriers," January 21, 1966. 

"Rehabilitation Act of 1973, P.L. 92-112," Rehabilitation Gazette , 17, 1974. 

Washington/Alaska Regional Medical Program, "Barrier-Free Design for the 
Disabled." 

Williams, Lawrence, A., "Only a Step Away," Nation's Cities , February, 1968, p. 
21. 

Atlanta Regional Commission, "Construction Codes in the Atlanta Metropolitan 
Area, A Survey of Current Practices," July, 1974. 

Committee on Barrier-Free Design, Newsletter , No. 27, March, 1975. 

The Council of State Governments, On Growing Old (Study on Aging) , Lexington, 
Kentucky, 1973. 

Kliment, Stephen A., The American Institute of Architects, The Rehabilitation 
Services Administration of HEW, Into the Mainstream; A Syllabus for a Barrier- 
Free Environment . 

Iowa Chapter AIA, Easter Seal Society for Crippled Children and Adults of Iowa, 
Iowa's Governor's Committee on Employment of the Handicapped, Accessibility, 
The Law and Reality: A Survey to Test the Application and Effectiveness of 
Public Law 90-480 in Iowa, 1974. 



144 



National Center for Law and the Handicapped, Inc., "Recent Legislation," 
Newsline , October, 1974: "New decisions," Vol. 2, September, 1974; and "New 
Florida Legislation," Vol. 2, August, 1974. 

The President's Committee on Employment of the Handicapped and the Easter 
Seal Society, "People Are Asking For and Displaying the Symbol of Access." 

State University Construction Fund, Making Facilities Accessible to the Physically 
Handicapped , Albany, New York, July, 1967. 

Cotter, S.R., Degraff, A.H., State University Construction Fund, Architectural 
Accessibility for the Disabled of College Campuses , Albany, New York, July, 
1967. 

The White House Conference on Handicapped Individuals, Awareness Papers , Vol. 
1, Washington, D.C., May 23-27, 1977. 

Barrier Free Design for the Elderly and Disabled , Syracuse University, 1976. 

Curtiss, Frances A., & Fowler, Beth, Ph.D., "Barrier-Free Design, A Way of 
Independent Living," Proceedings of the World Confederation of Physical Therapy , 
June 19, 1974. 

Some Significant Regulations 

American National Standards Institute, Inc., American National Standards 
Specifications for Making Buildings and Facilities Accessible To, and Usable By, 
the Physically Handicapped , A117.1, New York, ANSI, 1961. 

Department of Housing and Urban Development, Low-Rent Housing Precon- 
struction Handbook , Chapter 3, (7410.1) Section 1, "Criteria," Sub-Section 3-7b.2, 
January, 1974. 

Department of Defense, Department of Defense Construction Criteria Manual , 
Instr. 4270. 1-M, Section 5-1.6, "Provisions for Physically Handicapped." 

Department of Transportation, Federal Regulations , "Codification of Require- 
ments of Elderly and Handicapped Transportation Services," February 26, 1975. 

U.S. Postal Service, Design Guidelines for Postal Facilities , Washington, D.C., 
June, 1974 (revised November, 1974). 

"Accessibility of Public Buildings to the Physically Handicapped," Hearing before 
the Subcommittee on Public Buildings and Grounds of the Committee of Public 
Works, U.S. Senate, 90th Congress, 1st Session, July 17, 1967. 

"Usefulness of the Model Cities Program to the Elderly," Hearings before the 
Special Committee on Aging, U.S. Senate, 91st congress, 1st Session, Part 7, 
October 14-15, 1975. 

145 



"Transportation and the Elderly: Problems and Progress," Hearings before the 
Special Committee on Aging, U.S. Senate, 93rd Congress, 2nd Session, Parts 1 and 
2, February 25, 28, 1974. 

"Vocational Rehabilitation Services: Oversight Hearings," Select Subcommittee 
on Education of the Committee on Education and Labor, House of Represen- 
tatives, 93rd Congress, 1st Session, Part 2, November 30 and December 10, 1973. 

Proceedings, Reports, Position Papers 

Proceedings of the National Institute on Making Buildings and Facilities 
Accessible To and Usable By the Physically Handicapped, November 21-24, 1964, 
A National Institute on Architectural Barriers sponsored by the National Society 
for Crippled Children and Adults and financed by the Vocational Rehabilitation 
Administration. 

Fregger, Stephan, "The Elderly Pedestrian," Florida Department of Transpor- 
tation, August, 1974. 

Surveys 

Dantona, Robert and Tessler, Benjamin, "Architectural Barriers for the Handi- 
capped: A Survey of the Law in the United States," Reprint, Rehabilitation 
Literature, 28: 34-43, February, 1967. 

Department of Urban Studies, National League of Cities, State and Local Efforts 
to Eliminate Architectural Barriers to the Handicapped , November, 1967. 

U.S. Publications 
Congressional Record 

"National Health Priorities," House, December 10, 1974, 

"Standards for Making Buildings Usable by the Physically Handicapped," 87th 
Congress, 2nd Session, Washington, D.C., 1962. 

General Services Administration 

"Architectural Criteria," U.S. Government Manual, 1974-75, Office of Federal 
Register, National Archives and Records Service. 

"Criteria for a Federal Office Building," Washington, D.C., November 3, 1971. 

Public Buildings Service, Day on Wheels , Washington, D.C., January, 1975. 

Department of Health, Education and Welfare 

Vocational Rehabilitation Administration, "Help for the Disabled through Voca- 
tional Rehabilitation," January, 1963. 

146 



Memorandum from Director of Policy Research and Legislation to the Commis- 
sioner, Office of Human Development, Rehabilitation Services Administration, 
March 5, 1975, RE: Recent Developments in Housing for the Handicapped. 

"Regulations Governing the Programs Administered by the Vocational Rehabilita- 
tion Administration," August, 1967. 

Baker, M., Fischetti, M., Williams, L., Young, E., Final Report State and Local 
Efforts to Eliminate Architectural Barriers to the Handicapped , National League 
of Cities. 

"A Summary of Selected Legislation Relating to the Handicapped, 1963-67," May, 
1968. 

"A Summary of Selected Legislation Relating to the Handicapped, 1971," 1972, 
1974, 1975-76. 

"Affirmative Action Plan for Employment of Handicapped Individuals and Disabled 
Veterans," PHS, 1976. 

The Vocational Rehabilitation Act Amendment of 1965, Public Law 89-333, Fact 
Sheet , 1965. 

"Office of Handicapped Individuals," A Descriptive Pamphlet, HEW 391. 

Programs for the Handicapped , Office of Handicapped Individuals, May 20, 1977. 
U.S. Department of Transportation 

"Planning and Designing," Chapter 3, 1974. 

HUD Programs That Can Help the Handicapped , Washington, D.C., May, 1977. 
U.S. Postal Service 

Design Guidelines for Postal Facilities , June, 1974, (revised November, 1974). 

U.S. Department of Transportation 

Urban Mass Transportation Administration, "Elderly and Handicapped Transpor- 
tation Services, Federal Register," February 26, 1975, 40. 

Federal Highway Administration, Federal-Aid Highway Program Manual , May 27, 
1975. 

UMTA Office of Public Affairs, "Summary of Urban Mass Transportation 
Activities to Improve Transportation for Elderly and Handicapped Persons," 
Washington, D.C., January, 1977. 

147 



Architectural and Transportation Barriers 
Compliance Board 

"Architectural and Transportation Barriers Compliance Board," 8, 76. 

"Access America: The Architectural Barriers Act and You," 1976. 

"Access Travel: A Guide to Accessibility of Airport Terminals," 1977. 

U.S. Conferences 

1971 White House Conference on Aging, a Report to the Delegates from the 
Conference Sections and Special Concerns Session, November 28-December 2, 
1971. 

1971 White House Conference on Aging, Toward a National Policy on Aging, Final 
Report , Vols. 1 and 2, 1972. 



148 




iPPii "I^ll^lli 






;||^|||||||I 




PROCEDURAL FORMS HANDEPED PROJECT 
Checkoff Form for Survey of Police Files 



1. 


Victim's name: 




Code Number 


2. 


Date of Accident: 


Wed. Thur 




3. 


Day of Week: Sun. Mon. Tues. 


s. Fri. Sat. 


4. 


Hour: AM PM 






5. 


Number and Street where accident 


occurred: 




6. 


Intersecting Street (if any): 






7. 


Victim's Sex: M F Age: 


Address: 




Injury Code: 12 3 4 5 






8. 


Road Defects 


9. Traffic 


Control 




1. ( ) None 


1. ( ) 


Marked traffic lanes 




2. ( ) Holes, ruts, bumps 


2. ( ) 


Stop & Go signal 




3. ( ) Under construction 


3. ( ) 


Stop & Yield Sign 




4. ( ) Slippery 


4. ( ) 


Other warning sign 




5. ( ) 


5. ( ) 





10. Light Conditions 

1. ( ) Daylight 

2. ( ) Dusk 

3. ( ) Dawn 

4. ( ) Darkness, street lighted 



6. ( ) No control present 
11. Road Type 

1. ( ) 1 Lane 

2. ( ) 2 lanes 

3. ( ) 3 lanes 

4. ( ) 4 or more lanes 



5. ( ) Darkness, street not lighted 5. ( ) Divided or one way 

6. ( ) Freeway, Parkway 

7. ( ) Unpaved 



"^ 



149 



12. Road Character 



~N 



1. ( 


) Straight road 


2. ( 


) Curve 


3. ( 


) Level 


4. ( 


) On grade 


5. ( 


) Hill crest 


13. Pedes 


jtrian Action: Going: N S E W 


Along 


j or across from 


1. ( 


) Crossing at intersection with signal 


2. ( 


) Crossing at intersection against signal 


3. ( 


) Crossing at intersection, no signal 


4. ( 


) Crossing at intersection, diagonally 


5. ( 


) Crossing between intersections 


6. ( 


) Walking in roadway with traffic 


7. ( 


) Walking in roadway against traffic 


8. ( 


) Pushing or working on vehicle 


9. ( 


) Other working in roadway 


10 ( 


) Playing in roadway 


11. ( 


) Lying in roadway 


12. ( 


) Standing in roadway 


13. ( 


) Standing off roadway 


14. ( 


) Crossing from behind vehicle 


15. ( 


) Entering vehicle 


16. ( 


) Exiting vehicle 


14. Diagi 


'am: 


15. Any < 


)ther information: 



to 






150 



HANDEPED STUDY 



HOSP. 



FI 



REPORT NO. 



GUIDELINES FOR TELEPHONE INTERVIEWS 
WITH PEDESTRIANS WHO HAVE BEEN INVOLVED IN ACCIDENTS 



„ . — — — — , 


Subject's Last Name First 


Middle Initial 




Street (Apt.) City 


State 


Zip 


Age Sex Telephone 






Where did it happen? 






When? 






Cause? 






Problem as stated by patient? 







INTERVIEW: 



Attempts to Contact 



Completed Date 



1. Is your name 



2. We are conducting research to try to find out how to make the country safer 

for pedestrians. As you (your ) have/has recently been involved in an 

accident, we would like to ask you a few questions that may help us to prevent 
other people from having accidents or injuries. 

If you would rather not discuss the accident, please say so; I won't take up any 
more of your time, and we won't call you again. 

Your name will not be revealed to anyone unrelated to the study. 

May I ask you some questions about the accident? 



151 



3. We are interested in any physical handicaps you may have had at the time of 
the accident. 



a) Did you have good vision? 



i.e., vision in walking is very weak or poor). 



(If no, find if legally blind or severity— 



b) Did you have good hearing? 

i.e., hearing is very weak or poor). 



(If no, find if legally deaf or severity— 



c) Did you use a crutch, a stick or any walking aid or a wheelchair? 
What? 



d) Did you have a limp or any physical condition that made it difficult for you 
to walk? What? ______ 

e) Did you have anything wrong with your hands, arms or shoulders? 



f) Had you taken any medication, stimulants or drugs a short while before the 
accident? What? 

If subject is not over 65 or pre-school or of school age and was not handicapped at 
time of accident, END INTERVIEW. 

4. Would you describe to me what happened in the accident, and what do you 
think caused it? 



INTERVIEWER' S DIAGRAM OF THE ACCIDENT 
Accident Account: 



NOTE: If the accident was not a pedestrian accident, END INTERVIEW. 
Pedestrian accidents for this study may be in or out of doors, and include 
accidents in corridors, on steps, ramps, escalators, streets, sidewalks, 
driveways, entrances, hallways, etc., but not in domestic kitchens, bathrooms, 
bedrooms, livingrooms, etc. If in doubt, proceed with the interview. 

NOTE: After Question 4, the remaining questions may be asked in any sequence 
and in any form; and further questions not listed here may be posed. The 
questions shown are illustrative and are intended to provide a topic check list. 



152 



5. Were the weather conditions at the time of the accident a problem? 
Rain Snow Fog Wind Sleet Dust Ice Other 

6. At the time of the accident, were you: 

Going to work Going to school Going to car or bus 

Going shopping Going to recreation Playing Other 

7. Were you: Walking Running Hurrying Other 

8. Was the accident: 

On a road On a sidewalk On a driveway 

On steps In a corridor In a building Other 

QUESTIONS 9-15 REFER TO ACCIDENTS INVOLVING VEHICLES 

9. If the accident was on a road, were you: 

Crossing at a street intersection 

Not crossing at a street intersection 

Crossing from behind a parked vehicle 

Getting off a vehicle 

Walking in the roadway with traffic 

Walking in the roadway against traffic 

Playing in the roadway 

Standing in the roadway 

Moving onto the roadway from the curb 

Moving off the roadway onto the curb 

Other 

10. If the accident involved a vehicle, was it: 

Moving straight ahead Making a right turn 

Making a left turn Slowing or stopping 

Starting in the roadway Starting from a parked position 

Backing Passing 

Changing lanes or merging Driving off the roadway 

Other 

11. At the time of the accident, were you looking: 

Straight ahead Behind To both sides 

Right side only Left side only Up 

Down Generally around Other 

153 



12. Were you looking at: 

Moving vehicles Traffic lights 

Other people Other non-moving objects 

The street or sidewalk ahead Curbs 

Roadside items or street furniture Other 

13. What did you do to avoid the accident? Did you: 

Take no action— unaware of need 

Take no action— insufficient time 

Take no action— walked or ran into vehicle 

Stopped— remained in place 

Walked— continued crossing 

Walked— returned to roadside 

Ran— returned to roadside 

Other 



14. Would you say that you: 

Took a risk 

Moved out too quickly to be seen 

Did not search adequately 

Did not pay attention to the traffic 

Walked against the signal 



Walked too slowly 

Ran into the road 

Looked in the wrong direction 

Tried to beat the vehicle 

Jaywalked 



15. Do you think the roadway was dangerous because: 

The roadway was inadequately lit 

There were no roadway lights 

There was no sidewalk 

There were no shoulders or they were inadequate 

You were blinded by the sun 

You couldn't see because of a parked vehicle 

You couldn't see because of a moving vehicle 

You couldn't see because of standing traffic 

Other 

16. Did you: Slip Trip Stumble Lose balance Other 

17. What caused this? 






154 



/ 

18. Did the accident happen because of: 

Uneven surface Slippery surface 

Loose or broken surface Couldn't see surface clearly 

A curb A threshold or step 

Repairs of sidewalk A grating 

Steps or stairs Something projecting 

A pole or street furniture A ramp 

Too many people around Insufficient space 

Other 

19. Was the lighting good enough to see properly? Was it: 
Daylight Twilight Dark with no lighting Dark with no road lighting Other 

20. Were you walking alone? Accompanied Other 
THANK YOU FOR YOUR COOPERATION 



155 



HANDEPED STUDY 
Field Investigation of Accident Site 



Accident Number 
Investigators 



Location _________ 

Date of Investigation 



PHOTOGRAPH LOG: 
No. Description 
1. 






use 


FIXED OBJECT LOG: 

Object Size 
1. 


2. 






2. 


3. 






3. 


4. 






4. 




years 


old) 


5. 




6. 


QUESTIONS: 

1. Could a child (5 


this street? 


Why/Why not? 





2. Could a blind person use this street? 
Why/Why not? ______________ 



3. Could a deaf person use this street? 
Why/Why not? ____ 



4. Could a person in a wheelchair use this street? 
Why/Why not? _____________„____ 



5. Could other categories of handicapped people use this street? 
Which categories? ________ 

Why/Why not? 

COLLISION DIAGRAM: 



156 



Field Study Instructions 



Equipment : City map, mileage log, acci- 
dent report form, pencil, straightedge, 
police report information (if available), 
interview of accident victim, roll-a-tape, 
50-foot steel tape, and camera. 

Preliminary ; Complete one accident re- 
port for each pedestrian accident or one 
accident report for each group of pedes- 
trian accidents if they are clustered. 

Condition Diagram : 

1. Location : Label all streets by name. 
If the site is not close to an inter- 
section, label the street address of 
several nearby buildings; show the 
approximate direction of the North 
arrow. 

2. Street : Measure the curb to curb 
width of all streets; show the number 
of traffic lanes in each direction; if 
the street is a one-way street, show 
the direction of traffic movement; if 
the accident occurred at an inter- 
section, measure both streets. If the 
intersection of the two streets is not 
approximately 90 degrees, make a 
rough measurement of the angle of 
intersection; also, "tie down" the lo- 
cation and measure the length and 
width of any traffic islands or other 
pedestrian facilities in the street. 

3. Sidewalks : Measure the width of all 
sidewalks; also, measure the offset 
from the street to the sidewalk. 
Indicate the locations where no side- 
walks exist and label each sidewalk 
type (concrete, dirt, gravel, etc.). 

4. Curbs : Measure the heights of all 
curbs. Indicate the locations where 
curbs do not exist. 



5. Pavement markings : Indicate the 
location of all pavement markings 
(stop lines, crosswalks, pavement 



6. 



7. 



8. 



9. 



word messages); 
all crosswalks. 



measure the width of 



Traffic signals : Indicate the location 
of all traffic signals. "Tie down" any 
post mounted signals. Note the con- 
figuration of each traffic signal face 
(the number of optical units and their 
indication, particularly any arrows 
for turning movements); indicate 
where separate pedestrian signals 
"WALK, DON'T WALK" are provided. 

Signs : Indicate the location and 
message of all important signs, ("PED 
XING, STOP, YIELD," etc.). 

Fixed objects : "Tie down" all fixed 
objects which might restrict sight 
distance; measure the exact height 
above the ground and the approxi- 
mate shape of the object. 

Parking : Indicate all locations where 
parking is permitted and/or present; 
measure the width of the parking 
space and its distance from the inter- 
section or crosswalk (if applicable). 



10. Street furniture : Indicate the loca- 
tion of all street furniture (newspaper 
stands, benches, trash barrels, etc.). 
Measure the approximate height and 
shape of each object. 

11. Bus stops : Indicate the location of all 
bus stops. "Tie down" the location of 
all bus stop posts. 

12. Lighting : "Tie down" the location of 
all luminaries in the immediate area 
of the accident. 



157 



13. Miscellaneous ; Indicate the location 
of all driveways, curb cuts, and sewer 
grates; show the directional orienta- 
tion of the grates (parallel or perpen- 
dicular to the curb). 

Collision Diagram : 

1. Show the location of the accident as 
accurately as possible. 

2. Show the approximate path of the 
vehicle (if any). 

3. Show the approximate path of the 
pedestrian. 

4. If more than one pedestrian is includ- 
ed on a single accident report, label 
each pedestrian by the appropriate 
code number (examples: A296 or 
P1117). 

Photographs : 

Preliminary: In most cases, no more than 
four (4) photographs should be taken at 
each accident site. 



(sewer grates, street furniture at 
a crosswalk, etc.). 

d. Any unsafe pedestrian behavior 
that is witnessed (examples: 
crossing outside a crosswalk, 
crossing from between parked ve- 
hicles, crossing "against" a pedes- 
trian or vehicular traffic signal). 



1. Photograph any unusually hazardous 
conditions: 

a. Especially, sight distance prob- 
lems—from an adult eye (height, 5 
feet), and from a child or wheel- 
chair eye (height, 3 feet). Sight 
distance problems are any situa- 
tions which prevent the pedestrian 
and the vehicle from seeing each 
other. 

b. Signals or signs that are illegible 
or not clear, Photographs of the 
traffic signal from the pedes- 
trian's point of view could be 
particularly valuable. 

c. Any objects in the pedestrian's 
path which could be hazardous 



158 




PEDESTRIAN ACCIDENT SUMMARIES 
(See General Causes and Countermeasures, Part 1) 



1. Victim ; 67 year old female 

Handicap ; elderly, nervousness 

Description; The victim was walking 
aimlessly near her home on a rainy 
morning. She was trying to "settle 
her nerves." She started to cross a 
busy street in a crosswalk without the 
aid of a traffic control device. A 
vehicle, traveling in a straight line 
perpendicular to the crosswalk, hit 
the victim at the far side of the 
street in the crosswalk. 

Specific Causes; The victim's handi- 
cap. The victim's failure to look for 
vehicles as she was crossing the 
street. The failure of the driver to 
yield the right of way to the pedes- 
trian in the crosswalk. The provision 
of a crosswalk without a traffic 
control device on a busy street. 

General Causes; C2, C6, C8, C9. 

Specific Countermeasures: Remove 
the crosswalk at this intersection and 
direct pedestrian traffic to the adja- 
cent signalized intersection. Prose- 
cute the driver for failure to yield 
the right of way to the pedestrian in 
a crosswalk. Use a safety informa- 
tion program to convince pedestrians 
that drivers frequently violate traffic 
regulations. 

General Countermeasures: CM2, 
CM8, CM9. 

2. Victim 82 year old male 

Handicap ; elderly 

Description: The victim attempted 
to cross a busy street away from a 
crosswalk. He was hit and fatally 



injured by a vehicle near the middle 
of the street. The vehicle may have 
been speeding. 

Specific Causes: The victim's handi- 
cap. The victim's slow walking speed. 
The failure of the victim to use a 
nearby crosswalk. The provision of a 
nearby crosswalk without a traffic 
control device on a busy street. Pos- 
sibly the speed of the vehicle. 

General Causes: C2, C6, C7, C8. 

Specific Countermeasures: Inspect 
the vehicular and pedestrian traffic 
patterns at the intersection for the 
possible installation of a traffic sig- 
nal. Use a safety information pro- 
gram to inform elderly people about 
the dangers of crossing a street away 
from a crosswalk. 

General Countermeasures: CM2, 
CM8. 

3. Victim : 84 year old male 

Handicap : elderly, poor vision, poor 
hearing, uses walking cane. 

Description: The victim attempted 
to cross a busy street away from a 
crosswalk. Due to the rainy weather 
and his poor vision, he thought he was 
crossing in a marked crosswalk. The 
driver of the vehicle was unable to 
avoid the collision. 

Specific Causes: The victim's disabil- 
ities. The weather conditions at the 
time of the accident. The victim's 
failure to use the available cross- 
walks. The proximity of the vehicu- 
lar traffic and the pedestrian traffic. 

General Causes: C3, C5, C7, C8. 



159 



Specific Countermeasure: Install a 
positive pedestrian barrier near the 
curb on both sides of the street. 



General Counter measures: 

CM8. 

4. Victim: 73 year old female 



CM3, 



Handicap : elderly 

Description: The victim was standing 
on the front steps of her home. She 
was cleaning the palm leaves which 
hang close to the steps. The victim 
stepped backwards off a step and fell. 

Specific Causes: The victim's handi- 
cap. Personal negligence. The in- 
ability of the victim to regain her 
balance. 

General Cause: C8. 

Specific Countermeasure: Provide 
information to elderly people about 
how and why to avoid dangerous 
situations such as walking down steps 
backwards. 



Specific Countermeasures: Clean up 
the pavement around the service sta- 
tion area. Remove the grease and oil 
which accumulates on the pavements 
at these locations. 

General Countermeasures: CM8, 
CM10. 



6. Victim : 82 year old female 

Handicap : elderly 

Description: The victim was exiting 
from the senior citizen's home where 
she resides. She walked across the 
sidewalk toward the curb of the 
driveway. As the victim attempted 
to dismount from the curb, she 
caught her heel on the lip of the curb. 
This caused her to fall into the 
driveway. 

Specific Causes: The victim's handi- 
cap and the design of the curb and 
sidewalk. 

General Causes: CI, C8. 



General Countermeasure: CM8. 

5. Victim : 81 year old female 

Handicap : elderly, partially deaf, 
difficulty with walking 

Description: The victim was exiting 
from the front passenger seat of an 
automobile at a service station. It 
was raining and the pavement was 
wet and slippery. The victim fell 
when she tried to stand on the wet 
pavement. 

Specific Causes: The victim's handi- 
cap. The wet and slippery pavement. 

General Causes: C8, Cll. 




Specific Countermeasure: Remove 
the lip of the curb. 

General Countermeasures: CM1, 
CM8. 

Victim : 76 year old female 

Handicap : elderly 

Description: The victim was walking 
briskly on a sidewalk. She stubbed 
her toe on a rough spot on the 
sidewalk and fell. 

Specific Causes: The victim's handi- 
cap and the rough spot on the pave- 
ment. 



160 



General Causes: CI, C8. 

Specific Countermeasures: Provide 
information to elderly people about 
how and why to avoid dangerous 
situations such as rough spots on the 
pavement. Repair the sidewalk pave- 
ment. 

General Countermeasures: CM1, 
CM8. 



8. Victim : 74 year old female 

Handicap : elderly 

Description: The victim was walking 
across a major arterial street in a 
crosswalk while traffic on the street 
was stopped by a red light. A vehicle 
made a right turn from a parking lot 
behind her onto the street. The 
driver did not see the victim because 
a bright sun was in his eyes. The 
vehicle struck the victim, knocking 
her to the ground. 

Specific Causes: The driver's failure 
to yield the right of way to the 
pedestrian in the crosswalk. The 
presence of a bright sun in the dri- 
ver's eyes. 

General Causes: C9, C12. 

Specific Countermeasures: Prosecute 
the driver for failure to yield the 
right of way to the pedestrian in the 
crosswalk. 

General Countermeasures: CM9. 



9. Victim : 79 year old male 
Handicap : elderly 
Description: The victim started to 



run across an arterial street in a 
crosswalk in order to catch a bus that 
was stopped across the street at a red 
light. He looked for vehicles to the 
right, but not to the left. A vehicle 
traveling on an intersecting street 
behind him made a right turn and 
struck the victim. 

Specific Causes: The victim's failure 
to look for vehicles to the left before 
crossing the street. The driver's 
failure to yield the right of way to 
the pedestrian in the crosswalk. The 
presence of shrubbery near the inter- 
section which obstructed visibility of 
the victim by the driver. 

General Causes: C5, C9, C12. 

Specific Countermeasures: Provide 
information to the elderly about safe 
pedestrian behavior. Prosecute the 
driver for failure to yield the right of 
way to the pedestrian in the cross- 
walk. Remove the shrubbery near the 
intersection. 

General Countermeasures: CM8, 
CM9, CM11. 

10. Victim : 76 year old female 

Handicap : elderly, wears hearing aid, 
weak from a recent illness. 

Description: The victim was walking 
hurriedly on a sidewalk along a major 
arterial street. She tripped on the 
sidewalk and fell to the ground, in- 
juring her knee. 

Specific Causes: The victim's handi- 
caps. The poor condition of the 
sidewalk surface. 

General Causes: C2, C8 



161 



Specific Countermeasures: Provide 
information to the elderly about safe 
pedestrian behavior. Improve the 
sidewalk surface. 

General Countermeasures: CM2, 
CM8 

11. Victim : 80 year old female 

Handicap : elderly 

Description: The victim was starting 
to walk across a collector street on a 
rainy evening at twilight. She was 
looking ahead and at moving vehicles 
on the street. As she stepped from 
the curb onto the street, a vehicle 
making a left turn from a sandy, 
unpaved driveway onto the street 
struck the victim, knocking her to the 
ground. 

Specific Causes: The victim's failure 
to cross in a crosswalk or at an 
intersection. The time of day, the 
weather conditions, and the presence 
of shrubbery along the driveway, all 
of which decreased visibility of the 
victim by the driver. 

General Causes: C7, C12 

Specific Countermeasures: Provide 
information to the elderly about safe 
pedestrian behavior. Remove the 
shrubbery along the driveway. 



General Countermeasures: 
CM11 

12. Victim: 80 year old female 



CM8, 



Handicap : elderly, uses a cane, has 
heart difficulty which causes dizzi- 
ness. 

Description: The victim was taking a 
long walk. She had to cross a street 



to use the sidewalk on the opposite 
side. While she was crossing the 
street she fell on an uneven drainage 
grating. 

Specific Causes: The victim's handi- 
caps. The location of the grating in 
the typical pedestrian path. The lack 
of a marked crosswalk away from the 
drainage grating. 

General Causes: C2, C8. 

Specific Countermeasures: Elevate 
the grating to an approximately level 
surface. Make a clear and continuous 
path across the intersection. Extend 
the sidewalk to the curb. Use cross- 
walk stripes to route the pedestrians 
away from the drainage gratings. 
Install STOP signs on the Stillwood 
Road approaches to the intersection. 

General Countermeasures: CM2, 
CM8. 

13. Victim : 26 year old male 

Handicap : cerebral palsy (uses 
crutches, brace on right leg), intox- 
icated. 

Description: The victim had been 
drinking in a bar and had walked 
outside for fresh air. While walking 
on a deck in the rear of the building, 
he lost his balance and fell off the 
deck about 8 feet to the ground 
below, injuring his chest. 

Specific Causes: The victim's handi- 
caps. The failure to provide a railing 
at the edge of the deck. 

General Causes: CI, C3, C12 

Specific Countermeasures: Provide a 
railing at the edge of the deck. 
Provide information to the public, 



162 



and particularly to the handicapped, 
about the dangers associated with the 
overconsumption of alcoholic bev- 
erages. 

General Countermeasures: CM1, 
CM3, CM2 

14. Victim : 8 year old female 

Handicap : child, very weak hearing 

Description: The victim was running 
across an arterial street on a rainy 
evening at twilight. She was looking 
at the sidewalk ahead, and not at 
vehicular traffic on the street. A 
vehicle traveling on the street struck 
her, knocking her to the ground. 

Specific Causes: The victim's failure 
to cross in a crosswalk or at an 
intersection. The victim's failure to 
consider vehicular traffic on the 
street before crossing. The failure of 
the victim's parents to educate her 
about safe pedestrian behavior. The 
time of day, the weather conditions, 
and the presence of a large tree along 
the street, all of which decreased 
visibility of the vehicle by the victim. 

General Causes: C5, C7, CIO, C12 

Specific Countermeasures: Encour- 
age parents to educate their children 
about safe pedestrian behavior. Pro- 
vide information to school children 
about safe pedestrian behavior. 

General Countermeasures: CM6, 
CM7. 

15. Victim : 43 year old male 

Handicap : taking medication for high 
blood pressure; poor vision 



Description: The victim was waiting 
for the traffic signal to change at a 
busy intersection. When the signal 
changed, a vehicle stopped in the 
crosswalk. Several pedestrians 

crossed in front of the vehicle. The 
victim and several other pedestrians 
attempted to cross behind the vehicle 
in the crosswalk. The driver backed 
up and hit the victim. 

Specific Causes: The victim's handi- 
cap. The driver's indiscretion in 
stopping across the crosswalk and 
carelessly backing up. The absence 
of a stop line at this approach. 

General Causes: C2, C9 

Specific Countermeasures: Paint a 
stop line behind the crosswalk on the 
south approach to the intersection. 
Prosecute the driver for stopping 
across a crosswalk and backing into a 
crosswalk. 

General Countermeasures: CM2, 
CM9 

16. Victim : 10 year old male 

Handicap : child, poor vision without 
eyeglasses 

Description: The victim attempted 
to run across a busy street away from 
a crosswalk. He was not wearing his 
eyeglasses. This apparently caused 
him to run into a moving vehicle. 
The vehicle was not speeding. 

Specific Causes: The victim's handi- 
caps. The victim's failure to wear his 
eyeglasses. The victim's failure to 
use the nearby crosswalk. The pro- 
vision of a nearby crosswalk without 
a traffic control device on a busy 
street. 



163 



General Causes: C2, C5, C7, CIO. 

Specific Counter measures: Inspect 
the vehicular and pedestrian traffic 
pattern at the intersection for the 
possible installation of a traffic sig- 
nal. Use a school safety program to 
make children aware of the danger 
involved in crossing outside the cross- 
walk. 

General Countermeasures: CM2, 
CM6, CM7 



17. Victim : 64 year old female 

Handicap : poor vision in dim light 

Description: The victim was walking 
in an interior corridor. As she start- 
ed to descend some steps, she lost her 
balance and fell. The corridor was 
dimly lighted and the victim could 
not see the steps too well. 

Specific Causes: The victim's handi- 
cap. The inadequate illumination of 
the steps. 

General Cause: CI 

Specific Countermeasure: Improve 
the illumination of the steps. 



General Countermeasure: CM1 



18. Victim : 5 year old female 

Handicap : child, very weak vision 

Description: The victim was walking 
across a collector street. She saw an 
approaching vehicle traveling on the 
street, but continued to walk into the 
vehicle. The vehicle struck the vic- 
tim. 



Specific Causes: The victim's handi- 
cap. The victim's failure to consider 
vehicular traffic on the street while 
crossing. The failure of the victim's 
parents to buy her glasses, and to 
educate her about safe pedestrian 
behavior. 

General Causes: C6, CIO 

Specific Countermeasures: Encour- 
age parents to have their children's 
vision checked and, if necessary, cor- 
rected. Encourage parents to edu- 
cate their children about safe pedes- 
trian behavior. 

General Countermeasures: CM6 



19. Victim : 10 year old male 

Handicap : child 

Description: The victim and a friend 
were going to the store. They at- 
tempted to cross a busy street away 
from a crosswalk. The friend safely 
ran across the street. The victim was 
hit by a skidding vehicle. 

Specific Causes: The victim's handi- 
cap. The victim failed to look for 
conflicting vehicular traffic and he 
failed to use the nearby crosswalk. 
The provision of a nearby crosswalk 
without a traffic control device on a 
busy street. 

General Causes: C2, C5, C7, CIO. 

Specific Countermeasures: Use a 
school safety program to emphasize 
the importance of checking for con- 
flicting vehicular traffic. Illustrate 
the proper use of a crosswalk. Pro- 
vide a traffic control device at the 
crosswalk or remove the crosswalk. 



164 



General Countermeasures: CM2, 
CM6, CM7 

20. Victim ; 10 year old male 

Handicap ; child 

Description: The victim was rushing 
to cross a busy street away from a 
crosswalk. He entered the street 
from behind a telephone pole without 
looking for conflicting vehicular traf- 
fic. The victim ran into the path of a 
moving vehicle. 

Specific Causes: The victim's handi- 
cap. The pedestrian failed to look for 
conflicting vehicular traffic. The 
pedestrian did not use the nearby 
crosswalk. The provision of a nearby 
crosswalk without a traffic control 
device on a busy street. 

General Causes: C2, C5, C7, CIO 

Specific Countermeasures: Use a 
school safety program to illustrate 
the dangers of crossing the street 
without looking for conflicting vehic- 
ular traffic. Emphasize the proper 
use of a crosswalk. Provide a traffic 
control device at the crosswalk or 
remove the crosswalk. 



General Countermeasures: 
CM6, CM7 

21. Victim: 4 year old male 



CM2, 



Handicap : child 

Description: During the confusion of 
another serious incident the victim 
was temporarily left unattended by 
his mother. The child wandered into 
a busy street from a small adjacent 
parking lot. The victim was struck by 
a vehicle in the street. 



Specific Causes: The victim's handi- 
cap. Temporary neglect by the par- 
ent. The lack of any delineation 
between the parking lot and the 
contiguous street. The absence of a 
sidewalk. 

General Causes: C3, CIO 

Specific Counter measure: Delineate 
the parking lot from the street by the 
use of a sidewalk or curb. 

General countermeasures: CM3, CM6 

22. Victim : 11 year old male 

Handicap : child 

Description: The victim was taking a 
shortcut on his way to school. He 
saw the approaching vehicle while he 
was at the side of the street but he 
thought that he could cross in front 
of the vehicle. His evaluation was 
incorrect and he was struck by the 
vehicle in the curb lane. The vehicle 
was unable to avoid the collision. 

Specific Cause: The victim's handi- 
cap. The pedestrian misjudged the 
speed of the approaching vehicle. 
The appearance of the pedestrian was 
unexpected and possibly obstructed 
by the overgrown weeds. The access 
across the railroad tracks available to 
the pedestrian is unsafe. 

General Causes: C2, C3, C5, C6, CIO 

Specific Countermeasures: Use a 
school safety program to teach child- 
ren how to judge the speed of an 
approaching vehicle. Remove the bus 
stop from this intersection. Erect a 
fence between the street and the 
railroad tracks. Encourage pedest- 
rians to use the crosswalk at the next 
intersection. 



165 



General Countermeasures: CM2, 
CM3, CM5, CM6, CM7 

23. Victim ; 12 year old male 

Handicap ; child 

Description; The victim dismounted 
from a school bus and waited at the 
side of the road. As the bus began to 
pull away the child ran across the 
street behind the bus. A speeding 
vehicle, traveling on the same street 
in the opposite direction, hit the 
victim as he ran across the street. 

Specific Causes: The victim's handi- 
cap. The victim failed to cross the 
street in front of the stopped school 
bus in accordance with proper safety 
procedures. The driver of the acci- 
dent vehicle was traveling too fast to 
avoid the collision. 

General Causes: C5, C7, C9, CIO 

Specific Countermeasures: Demon- 
strate the dangers of crossing behind 
a slow moving bus to the children and 
the bus drivers in a school safety 
program. Convince them that auto- 
mobile drivers frequently violate 
traffic regulations. Prosecute the 
driver for speeding. 

General Countermeasures: CM5, 
CM7, CM9 

24. Victim : 6 year old female 

Handicap : child 

Description: The child ran across the 
street toward her house. A vehicle, 
traveling in the downhill direction, 
was unable to avoid the collision. 
The accident occurred away from the 
intersection. 



Specific Causes: The victim's handi- 
cap. The failure of the victim to 
check for conflicting vehicular traf- 
fic. The use of a residential street as 
a through route. 

General Causes: C4, C5, CIO 

Specific Countermeasures: Use a 
temporary vehicular barrier to divert 
northbound traffic from Crest Street 
to Hatcher Avenue. Use a school 
safety program to teach children how 
to cross a residential street. 

General Countermeasures: CM4, 
CM6, CM7 

25. Victim : 10 year old male 

Handicap : child 

Description: The victim was on his 
way home from visiting his mother at 
work. He attempted to run across a 
street at a location away from a 
crosswalk. An unseen car came over 
a nearby hill in the far lane. When 
the boy saw the car, he "froze" and 
was struck by the vehicle in the 
street. 

Specific Causes: The victim's handi- 
cap. The failure of the victim to 
cross the street using the crosswalk 
at a nearby signalized intersection. 
The vertical curvature of the street. 
The lack of a sidewalk on the north 
side of the street. 

General Causes: C2, C3, C6, C7, CIO 

Specific Countermeasures: Improve 
the existing crosswalk at the signal- 
ized intersection. Repaint the cross- 
walk stripes and install pedestrian 
signals. Use a school safety program 
to inform children about the dangers 



166 



of crossing a street away from a 
crosswalk. A barrier on the sidewalk 
below the crest of the vertical curve 
might also be considered. 

General Countermeasures: CM2, 
CM3, CM7 

26. Victim ; 15 year old female 

Handicap ; child 

Description; The victim was going to 
school at the time of the accident. 
She attempted to run across the 
street away from a crosswalk without 
looking for conflicting vehicular traf- 
fic. The victim ran into the path of a 
following vehicle. 

Specific Causes: The failure of the 
pedestrian to check for conflicting 
vehicular traffic. The absence of a 
continuously paved sidewalk on the 
west side of the street. 

General Causes: C2, C5, C7 

Specific Countermeasures: Provide a 
clear and continuous pedestrian path 
across the intersection. Extend the 
paved sidewalk on the west side of 
Pryor Street from Melton Road to 
Thornton Road. 

General Counter measure: C2 

27. Victim : 6 year old male 

Handicap : child 

Description: The victim was walking 
to school in the early morning dark- 
ness. He started to cross a busy 
street in a crosswalk at a signalized 
intersection. The victim apparently 
obeyed the vehicular and pedestrian 
traffic signals. He was struck by a 



vehicle near the middle of the cross- 
walk. The vehicle apparently obeyed 
the vehicular traffic signal. 

Specific Causes: The pedestrian 
crossing time provided by the traffic 
signal is inadequate. The illumination 
of the intersection is also not suffi- 
cient. The pedestrian did not look for 
a vehicle as he was crossing the 
street. 

General Causes: C2, C6 

Specific Countermeasures: Modify 
the traffic signal to provide adequate 
pedestrian crossing time. Provide 
more illumination at the intersection 
or delay the start of the school day 
until daylight is sufficient. Use a 
school safety program to convince 
children that drivers frequently vio- 
late traffic regulations. 

General countermeasures: CM2, 
CM5, CM6, CM7 

28. Victim : 15 year old male 

Handicap : child 

Description: The victim was at- 
tempting to cross a busy street at a 
signalized intersection. He was try- 
ing to cross the street "against the 
light." Two cars in the curb lane 
stopped to let the victim cross. He 
was hit by a vehicle in the outside 
lane near the middle of the cross- 
walk. 

Specific Causes: The victim's indis- 
cretion in crossing without the proper 
right of way. The failure to provide a 
stop line on the intersection ap- 
proach. 

General Causes: C2, C6 



167 



Specific Countermeasure: Paint stop 
lines on the intersection approach 
behind the crosswalks. 

General Countermeasure: CM2 

29. Victim ; 4 year old female 

Handicap ; child 

Description: The victim attempted 
to cross a street away from a cross- 
walk. She ran in front of a vehicle 
and a collision occurred. The acci- 
dent location was near the victim's 
home and the victim was unac- 
companied. The child may have run 
from between parked vehicles and the 
accident vehicle may have been 
speeding. 

Specific Causes: The victim's handi- 
cap. The victim is too young to cross 
the street by herself. The vehicle 
was probably traveling too fast. The 
use of a residential street as a 
through street. 

General Causes: C3, C9, CIO 

Specific Countermeasure: Use a 
temporary vehicular barrier to divert 
traffic from Cooper Street. 

General Countermeasures: CM3, 
CM6, CM9 

30. Victim : 9 year old male 

Handicap : child 

Description: The victim was running 
through the school grounds on an 
errand. He entered the school park- 
ing lot from behind a seven foot stone 
wall. A vehicle, moving through the 
parking lot, was unable to avoid the 
collision. 



Specific Causes: The victim's handi- 
cap. The failure of the pedestrian to 
check for conflicting vehicular traf- 
fic. The design of the parking lot. 

General Causes: C2, C5, CIO 

Specific Countermeasures: Reverse 
the direction of vehicular circulation 
in the parking lot. Refocus the 
direction of the sidewalk in the park- 
ing island away from the stone wall. 
Remove parts of the parking lot and 
extend the stone wall for a short 
distance at a lower height. 

General Countermeasures: CM2, 
CM6, CM7 

31. Victim : 6 year old female 

Handicap : child 

Description: The victim attempted 
to cross a street in a crosswalk at an 
intersection of two sloping streets. A 
vehicle on the same street entered 
the intersection from the downhill 
approach. The vehicle apparently 
failed to obey the STOP sign and hit 
the victim in the crosswalk. 

Specific Causes: The failure of the 
vehicle to obey the STOP sign and to 
yield right of way to the pedestrian in 
the crosswalk. Also, the inability of 
the crossing pedestrian to see the 
approaching vehicle due to the slop- 
ing roadway. 

General Causes: C2, C5, C9 

Specific Countermeasures: Encour- 
age vehicles to come to a complete 
stop at this intersection. An addi- 
tional STOP sign on the uphill ap- 
proach would be appropriate. Use a 
safety information program to con- 
vince pedestrians that drivers fre- 



168 



quently violate traffic regulations. 



the pedestrian in the crosswalk. 



General Counter measures: CM 2, 
CM6, CM7, CM9 

32. Victim ; 4 year old female 

Handicap : child 

Description: The victim was holding 
her baby sitter's hand as she climbed 
some irregular stone steps at a park 
near her home. She stumbled on the 
steps and fell. 

Specific Causes: The victim's handi- 
cap. The child's inability to climb the 
steps. The design and condition of 
the steps. 

General Cause: CI 

Specific Countermeasures: Make 
"natural" pedestrian facilities as safe 
as possible without adversely affect- 
ing the original condition. Install 
hand rails next to the steps. Clear 
the steps of weeds, grass and over- 
hanging bushes. 



General 
CM10 



Countermeasures: CM1, 



33. Victim : 13 year old male 

Handicap : child 

Description: The victim was walking 
across a major arterial street in a 
crosswalk while traffic on the street 
was stopped by a red light. He was 
looking at the sidewalk ahead. A 
vehicle traveling on the street did not 
stop at the red light and struck the 
victim, knocking him to the ground. 

Specific Causes: The driver's failure 
to stop at the red light, and his 
failure to yield the right of way to 



General Causes: C9 

Specific Countermeasures: Prosecute 
the driver for failure to stop at the 
red light, and for failure to yield the 
right of way to the pedestrian in the 
cross walk. 

General Countermeasures: CM9 

34. Victim : 2 year old female 

Handicap : child 

Description: The victim was playing 
on a vacant lot. She lost her balance 
and fell backward into a sewer ditch, 
injuring her arm. 

Specific Causes: The failure of the 
victim's parents to educate her about 
safety and to supervise her properly. 

General Causes: CIO 

Specific Countermeasures: Encour- 
age parents to take more responsibili- 
ty for the education and supervision 
of their children. 

General Countermeasures: CM6 

35. Victim : 2 year old male 

Handicap : child 

Description: The victim was playing. 
He ran from behind a parked car onto 
a collector street. The driver of a 
vehicle traveling on the street did not 
see the victim entering the street. 
The vehicle struck the victim, knock- 
ing him to the ground. 

Specific Causes: The failure of the 
victim's parents to educate him about 
safety and to supervise him properly. 



169 



General Causes: CIO 

Specific Counter measures: Encour- 
age parents to teach their children 
not to play in streets, particularly 
those with high traffic volumes. 

General Counter measures: CM 6 



36. Victim : 3 year old male 

Handicap : child 

Description: The victim was playing 
with other children on a local street. 
As a vehicle backed from a driveway 
onto the street, the victim was push- 
ed by one of the other children into 
the vehicle. The vehicle struck the 
victim, knocking him to the ground. 

Specific Causes: The failure of the 
victim's parents to educate him about 
safety and to supervise him properly. 

General Causes: CIO 

Specific Countermeasures: Encour- 
age parents to teach their children 
not to play in streets. 

General Countermeasures: CM6 

37. Victim : 8 year old male 

Handicap : child 

Description: The victim was running 
across a local street. He was looking 
at the curb ahead, and not at vehicu- 
lar traffic on the street. A vehicle 
traveling on the street struck him, 
knocking him to the ground. 

Specific Causes: The victim's failure 
to cross in a crosswalk or at an 
intersection. The victim's failure to 
consider vehicular traffic on the 



street before crossing. The failure of 
the victim's parents to educate him 
about safe pedestrian behavior. 

General Causes: C5, C7, CIO 

Specific Countermeasures: Encour- 
age parents to educate their children 
about safe pedestrian behavior. Pro- 
vide information to school children 
about safe pedestrian behavior. 

General Countermeasures: CM6, 
CM7 

38. Victim : 8 year old male 

Handicap : child 

Description: The victim was running 
across a collector street on his way 
home from school. He was looking at 
other people ahead. A vehicle travel- 
ing on the street struck the victim. 

Specific Causes: The victim's failure 
to cross in a crosswalk or at an 
intersection. The failure of the 
victim's parents to educate him about 
safe pedestrian behavior. The lack of 
adequate horizontal sight distance 
between the driver and the victim 
resulting from the horizontal curva- 
ture of the street and the presence of 
vegetation along the street. 

General Causes: C5, CIO, C12 

Specific Countermeasures: Encour- 
age parents to educate their children 
about safe pedestrian behavior. Pro- 
vide information to school children 
about safe pedestrian behavior. 

General Countermeasures: CM6, 
CM7 



170 



39. Victim : 7 year old male 

Handicap : child 

Description: The victim had alighted 
from a school bus on a collector 
street and had walked around the 
front of the bus in order to cross the 
street. As he started to walk across 
the street, a vehicle traveling on the 
street passed the stopped school bus 
and struck the victim. 

Specific Causes: The driver's failure 
to stop behind the stopped school bus. 
The location of the school bus stop on 
a curve where it is not visible to 
drivers. 

General Causes: C2, C9 

Specific Countermeasures: Prosecute 
the driver for failure to stop behind 
the stopped school bus. Locate 
school bus stops where they are vis- 
ible to drivers. 



General Countermeasures: 
CM9 

40. Victim: 6 year old female 



CM2, 



Handicap : child 

Description: The victim was walking 
across a local street at an inter- 
section. She saw an approaching 
vehicle traveling on an intersecting 
street behind her, but assumed that 
the vehicle would stop at the stop 
sign. However, the vehicle did not 
stop; it made a right turn and struck 
the victim, knocking her to the 
ground. 

Specific Causes: The driver's failure 
to stop at the stop sign. The pres- 
ence of shrubbery near the inter- 
section which obstructed visibility of 



the victim by the driver. 

General Causes: C9, CI 2 

Specific Countermeasures: Prosecute 
the driver for failure to stop at the 
stop sign. Remove the shrubbery 
near the intersection 

General Countermeasures: CM9, 
CM11 



42. Victim : 8 year old female 

Handicap : child 

Description: The victim had alighted 
from a school bus on a collector 
street and had walked around the 
front of the bus in order to cross the 
street. As she started to walk across 
the street, a vehicle traveling on the 
street passed the stopped school bus 
and struck the victim, injuring her 
head and leg. 

Specific Causes: The driver's failure 
to stop behind the stopped school bus. 

General Causes: C9 

Specific Countermeasures: Prosecute 
the driver for failure to stop behind 
the stopped school bus. 

General Countermeasures; CM9 

43. Victim : 9 year old male 

Handicap : child 

Description: The victim was running 
across an arterial street on his way 
home from school without considering 
vehicular traffic on the street. A 
vehicle traveling on the street struck 
the victim, injuring his leg. 



171 



Specific Causes: The victim's failure 
to cross in a crosswalk or at an 
intersection. The victim's failure to 
consider vehicular traffic on the 
street before crossing. The failure of 
the victim's parents to educate him 
about safe pedestrian behavior. 

General Causes: C5, C7, CIO 

Specific Countermeasures: Encour- 
age parents to educate their children 
about safe pedestrian behavior. Pro- 
vide information to school children 
about safe pedestrian behavior. 

General Countermeasures: CM6, 
CM7 

44. Victim : 4 year old male 

Handicap : child 

Description: The victim started to 
run across a collector street without 
considering vehicular traffic on the 
street. A vehicle traveling on the 
street struck the victim, injuring his 
ankle. 

Specific Causes: The victim's failure 
to cross in a crosswalk or at an 
intersection. The victim's failure to 
consider vehicular traffic on the 
street before crossing. The failure of 
the victim's parents to educate him 
about safety and to supervise him 
properly. 

General Causes: C5, C7, CIO 

Specific Countermeasures: Encour- 
age parents to take more responsibili- 
ty for the education and supervision 
of their children. 

General Countermeasures: CM6 



45. Victim : 3 year old female 

Handicap : child 

Description: The victim started to 
run across a collector street without 
considering vehicular traffic on the 
street. A vehicle traveling on the 
street struck the victim, injuring her 
arm. 

Specific Causes: The victim's failure 
to consider vehicular traffic on the 
street before crossing. The failure of 
the victim's parents to educate her 
about safety and to supervise her 
properly. 

General Causes: C5, CIO 

Specific Countermeasures: Encour- 
age parents to take more responsibili- 
ty for the education and supervision 
of their children. 

General Countermeasures: CM6 

46. Victim 14 year old male 

Handicap : child 

Description: The victim had alighted 
from a bus on an arterial street and 
had walked around the front of the 
bus in order to cross the street on his 
way home from school. As he started 
to walk across the street, he saw an 
approaching vehicle traveling on an 
intersecting street ahead of him, but 
assumed that the vehicle would stop 
at the stop sign. However, the 
vehicle did not stop; it made a right 
turn and struck the victim, knocking 
him to the ground. 

Specific Causes: The driver's failure 
to stop at the stop sign. The victim's 
failure to cross in a crosswalk near 
the bus stop. 



172 



General Causes: C7, C9 

Specific Countermeasures: Prosecute 
the driver for failure to stop at the 
stop sign. Relocate the bus stop by 
the crosswalk. 



General Countermeasures: 
CM9 

47. Victim: 8 year old male 



CM2, 



Handicap : child 

Description: The victim was walking 
home across a collector street in a 
crosswalk while traffic on the street 
was stopped by a school safety patrol. 
A vehicle traveling on the street did 
not stop at the crosswalk and struck 
the victim, knocking him to the 
ground. 

Specific Causes: The driver's failure 
to stop at the crosswalk while the 
safety patrol stopped traffic, and his 
failure to yield the right of way to 
the pedestrians in the crosswalk. 

General Causes: C9 

Specific Countermeasures: Prosecute 
the driver for failure to stop at the 
crosswalk while the safety patrol 
stopped traffic, and for failure to 
yield the right of way to the pedes- 
trians in the crosswalk. Teach school 
children that drivers frequently vio- 
late traffic regulations. 

General Countermeasures: CM7, 
CM9 



48. Victim 10 year old male 
Handicap : child 
Description: The victim was walking 



at night across a local street while a 
vehicle on the street was stopped at a 
stop sign. The victim first waited to 
allow the vehicle to go, but the 
vehicle did not go. The victim then 
started to walk across the street 
(thinking that the vehicle would not 
go), but the vehicle went (the driver 
thinking that the pedestrian would 
wait) and struck the victim. 

Specific Causes: The misunderstand- 
ing on the part of both the victim and 
the driver. The driver's failure to 
yield the right of way to the pedes- 
trian at the stop sign. 

General Causes: C9 

Specific Countermeasures: Prosecute 
the driver for failure to yield the 
right of way to the pedestrian at the 
stop sign. 

General Countermeasures: CM9 

49. Victim : 7 year old female 

Handicap : child 

Description: The victim was playing 
behind a parked car on a local street 
and suddenly ran from behind the 
parked car into the street. A vehicle 
traveling on the street struck the 
victim, knocking her to the ground. 

Specific Causes: The failure of the 
victim's parents to educate her about 
safety. 

General Causes: CIO 

Specific Countermeasures: Encour- 
age parents to teach their children 
not to play in streets. 

General Countermeasures: CM6 



173 



50. Victim ; 6 year old female 

Handicap ; child 

Description; The victim had alighted 
from her parents' car across a col- 
lector street from her school and had 
walked around the front of the car in 
order to cross the street. As a 
vehicle made a left turn from the 
school driveway onto the street, she 
started to walk across the street. At 
the same time, a vehicle traveling on 
the street (whose view of the pedes- 
trian had been blocked by the turning 
vehicle) struck the victim, knocking 
her to the ground. 

Specific Causes; The victim's failure 
to cross in a crosswalk or at an 
intersection. The victim's failure to 
consider vehicular traffic on the 
street while crossing. The failure of 
the victim's parents to educate her 
, about safe pedestrian behavior. The 
failure of the victim's parents to use 
the school driveway to deposit her. 

General Causes: C6, C7, CIO 

Specific Countermeasures; Encour- 
age parents to educate their children 
about safe pedestrian behavior. En- 
courage parents to use the school 
driveway to deposit their children. 
Provide information to school child- 
ren about safe pedestrian behavior. 

General Countermeasures: CM6,CM7 



174 



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186 



Table 33 Age Distribution of Population by Region, United States 1970 



Age 


Northeast 


North 
Central 


South 


West 


Under 2 

2-5 

6-17 

18-64 

65-74 

75+ 


1,563,430 
3,319,014 
11,143,354 
27,815,521 
3,238,794 
1,960,590 


1,927,594 
3,987,683 
13,924,360 
31,004,602 
3,450,080 
2,277,344 


2,174,644 
4,414,643 
15,246,864 
34,916,583 
3,849,091 
2,193,542 


1,197,111 
2,381,295 
8,364,089 
19,765,637 
1,897,491 
1,198,570 


Total 
Population 


49,040,703 


56,571,663 


62,795,367 


34,804,193 


Urban 
Population 


39,449,818 


40,480,760 


40,539,961 


28,854,391 


SOURCE: 
Northeast: 

North Centr 
South: 

West: 


U.S. Summary: General Population Characteristics, 
Vol. 7 l, Part 1, Table 56, p. 282 and Table 57, p. 
286. 

a) New England - Maine, New Hampshire, Vermont, 
Massachusetts, Rhode Island, Connecticut. 

b) Middle Atlantic - New York, New Jersey, 
Pennsylvania. 

al a) East North Central - Indiana, Illinois, Michigan, 
Wisconsin, 
b) West North Central - Minnesota, Iowa, Missouri, 
North Dakota, South Dakota, Nebraska, Kansas. 

a) South Atlantic - Delaware, Maryland, D.C., 
Virginia, West Virginia, North Carolina, South 
Carolina, Georgia, Florida. 

b) East South Central - Kentucky, Tennessee, Ala- 
bama, Mississippi. 

c) West South Central - Arkansas, Louisiana, Okla- 
homa, Texas. 

a) Mountain - Montana, Idaho, Wyoming, Colorado, 
New Mexico, Arizona. 

b) Pacific - Washington, Oregon, California, Utah, 
Nebraska, Alaska, Hawaii 



187 



DISTRIBUTION OF POPULATION USING SPECIAL AIDS 



Table 34: Percent of Population Using Special Aid* by Age and Sex 
U.S., 1969 



No. of Aid 
(1) 



Males Using 

(1) one type of 
aid 

(2) two types of 
aid 

(3) three or more 
types of aid 

Total 



Under 15 
(2) 



2.6 



15-44 
(3) 



1.4 
0.1 



2.6 



1.5 



Age 



45-64 
(4) 



65 and 
Over 

(5) 



3.2 
0.4 



3.6 



11.0 
1.4 



12.4 



All 
Ages 

(6) 



3.0 
0.3 
0.1 
3.4 



Females Using 

(1) 

(2) 



(3) 



Total 



one type of 

aid 

two types of 

aid 

three or more 

types of aid 



1.8 



0.7 



1.8 



0.7 



2.6 
0.3 

2.9 



11.8 
1.6 

13.4 



2.6 
0.3 
0.1 
3.0 



♦Based on a sample of about 42,000 households (containing 
about 134,000 persons) interviewed during the 52 weeks of 
1969. 

SOURCE: "Use of Special Aids"— US, 1969, DHEW Vital and Health 
Statistics, National Center for Health Statistics, series 
10, No. 78. 



188 



Table 35: Number Using Special Aids per Thousand by Race, Family 
Income, Usual Activity and Limitation of Activity; 
U.S. 1969 



f 




Special Shoes 


Crutches 
Walker 


^\ 






Cane, Stick 


Artificial 


Other 


Characteristics 


Wheelchair 


and Brace 


leg or foot 


Aids 


(1) 


(2) 


(3) 


(4) 


(5) 


Race 










White 


2.1 


29.0 


5.0 


.7 


All Other 


* 


25.2 


2.5 


— 


Family Income 










Less than 5,000 


3.5 


50.0 


10.7 


— 


5,000-9,999 


1.7 


21.9 


2.8 


.7 


10,000 or more 


1.4 


21.9 


2.5 


— 


Usual Activity 










Usually Working 










<17+) 


♦ 


14.6 


2.5 


.7 


Usually Keeping 










House (female, 










17+) 


1.9 


36.9 


6.5 


— 


Retired (45+) 


11.8 


149.2 


25.7 


— 


Others (in- 










cluding -17) 


2.7 


21.8 


3.3 


— 


Chronic Activity 










Limitation 










Unable to 










Carry on 










Major Activity 


49.7 


236.0 


73.8 


— . 


Limited in 










Amount or 










Kind of 










Major Activity 


6.6 


121.4 


19.0 


— 


Limited, but 










not in Major 










Activity 


— 


92.5 


— 


_— 


Not Limited 


— 


13.5 


.5 


.3 


Total 


2.1 


28.5 


4.8 


.9 


♦Based on a sample of about 42,000 households (containing about 


134,000 persons) interviewed during the 52 weeks of 1969. 


SOURCE: "Use of Special Aids" - US, 1969, DHEW Vital and 


Health Statistics NationaLXenter for Health 
Statistics, series 10, No. 78. 



189 




MIL 
Tiillb 



PREVALENCE OF IMPAIRMENTS 



Table 36: Prevalence of Impairments (Except Paralysis or Absence) 
of Upper Extremity and Shoulder due to Injury and 
Number per 1,000 Population by Age and Selected 
Characteristics+ - U.S. 1971 



r 








A 




No. of Impairments (000) 


No. 


Der 101 


30 Population 


All 


Under 




65 <5c 


AU 


Under 




65 & 


Characteristics 


Ages 


45 


45-64 


Over 


Ages 


45 


45-64 


Over 


(1) 


(2) 


(3) 


(4) 


(5) 


(6) 


(7) 


(8) 


(9) 


Sex 


















Male 


1167 


602 


404 


160 


12.0 


8.7 


20.4 


19.5 


Female 


533 


206 


192 


134 


5.1 


2.9 


8.8 


12.0 


Family Income 


















under $5,000 


520 


177 


148 


195 


12.7 


7.8 


19.4 


18.5 


$5,000-9,999 


528 


278 


195 


56 


8.2 


5.9 


15.3 


12.7 


$10,000-14,999 


300 


180 


110 


* 


6.2 


4.8 


11.8 


* 


$15,000 or 


















more 


247 


137 


97 


* 


6.9 


5.4 


11.0 


* 


Current Employ- 


















ment Status 


















Currently 


















Employed 


991 


544 


388 


59 


12.8 


11.5 


14.4 


18.6 


Unemployed 


76 


* 


* 


* 


13.4 


* 


* 


* 


Not in Labor 


















Force 


632 


218 


179 


235 


5.3 


2.4 


13.3 


14.7 


All 


1699 


808 


596 


295 


8.4 


5.7 


14.3 


15.2 


+Similar distributions are also available by education 


of he* 


id of 


family. 






♦Applies to numbers too small to report. 






SOURCE: "Impairments due to Injury", US - 1971, ] 


3HEW, 


Vital 


and Health Statistics, National Center 


for H 


ealth 




Statis 


;tics, sc 


ides 10 


, Numbt 


sr 87. * 









190 






'V' 






DISTRIBUTION OF POPULATION WITH SEVERE AUDITORY IMPAIRMENT 



Table 37: Distribution of Population with Severe Auditory Impairment 
and of their Rates per Thousand Population by Race, Income, 
Education, Residence and Region each Classified by Age 



r 


Number of Persons (000) 


Rate per 1000 


Persons 


1 




Under 




65 <5c 




Under 




65 <3c 


Characteristics 


Total 


45 


45-64 


Over 


Total 


45 


45-64 


Over 


(1) 


(2) 


(3) 


(4) 


(5) 


(6) 


(7) 


(8) 


(9) 


Race 


















White 


1468 


263 


393 


813 


9.0 


2.4 


11.8 


52.3 


Nonwhite 


124 


42 


36 


45 


5.8 


2.5 


10.3 


34.4 


Income 


















Under $2,000 


562 


55 


121 


386 


24.9 


4.6 


26.2 


63.9 


$2,000-3,999 


349 


71 


89 


189 


10.7 


3.3 


14.1 


43.1 


$4,000-6,999 


305 


92 


87 


126 


5.0 


1.9 


8.0 


43.0 


$7,000 & over 


289 


70 


110 


110 


5.0 


1.7 


8.7 


47.3 


Unknown 


85 


17 


21 


47 


9.1 


3.0 


8.6 


39.8 


Education (17 


















years & over) 


















Under 9 years 


881 


68 


269 


544 


21.1 


4.1 


17.2 


56.5 


9-12 years 


419 


122 


109 


188 


8.1 


3.7 


7.6 


40.6 


13 years & over 


138 


23 


42 


73 


6.2 


1.6 


7.0 


36.7 


Unknown 


66 


4 


9 


54 


25.0 


3.9 


9.0 


88.2 


Residence 


















Urban 


996 


202 


260 


533 


7.9 


2.2 


10.0 


45.6 


Rural Nonfarm 


420 


69 


97 


254 


9.9 


2.3 


12.6 


64.8 


Rural Farm 


176 


34 


71 


71 


13.0 


3.7 


22.2 


55.7 


Region 


















Northeast 


289 


55 


88 


147 


6.3 


1.7 


8.9 


33.6 


North Central 


451 


79 


124 


247 


8.5 


2.1 


11.6 


47.2 


South 


590 


126 


149 


314 


10.6 


3.1 


13.6 


65.3 


West 


261 


44 


68 


149 


9.0 


2.1 


12.4 


60.8 


SOURCE: 


"Chara 


cteristk 


js of Pe 


rsons w 


ith Impa 


ired He 


aring", t 


JS July 




1962-J 


une 196 


3, DHEV\ 


1, Vital 


and Hea 


1th Ste.1 
No. 35. 


istics, IS 


fational 




Center 


for Hea 


1th Stati 


sties, Se 


ries 10, ] 


3 





191 



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192 



Table 39: Number (000) and Rate per 1000 Persons of Visually 
Impaired Persons 6 Years and Over, by Degree of 
Impairment According to Sex and Age 



f 






~"> 




Both Eyes ] 


[nvolved 






Male 


Female 


Cannot Read 


Can Read 


Cannot Read 


Can Read 


Age 


Newsprint 


Newsprint 


Newsprint 


Newsprint 


Male 


Female 


6-16 


__ 


47 


— 


60 


20,830 


20,126 


17-44 


25 


101 


48 


135 


30,872 


34,373 


45-64 


77 


221 


116 


301 


18,153 


19,449 


65-74 


65 


128 


123 


273 


5,031 


6,088 


75 + 


165 


154 


326 


267 


2,512 


3,390 


6-64 


118 


369 


171 


496 


69,855 


73,948 


65 + 


229 


282 


449 


540 


7,544 


9,479 


Total 


348 


651 


621 


1,036 


77,398 


83,426 


SOUR 


CE: "Characteristics of Visually Impaired Persons", U.S 


. - July 1963-June 




1964, DHEW, Vital and Health.Statistics, National Center for Health 




Statistic 


s, Series 10, ] 


^o. 46. 









V 



193 



- 



append!)! 



CAUSES FOR OBVIOUS CONFUSION AND/OR DISORIENTATION 



1. Alcoholism 

1) Social Research Group of George 
Washington University conducted 
a national survey in 1965 (Cisin, 
I.H., Paper presented before the 
American Association for the Ad- 
vancement of Science). 

Study Findings 

68% American adults (77% men 
and 60% women) drink—of which 
56% are moderate to infrequent 
drinkers, and 12% (4 men to 1 
woman) are heavy (including prob- 
lem) drinkers. 

2) Harold A. Mudford (Drinking and 
Deviant Drinking, U.S.A., 1963, 
Quarterly Journal of Studies on 
Alcohol, V. 25, 1964r 4 found 
that: 

a greater portion of drinkers are 
39 years old. Larger proportion of 
single males, those who live in 
cities, in Western states, with 
least education and low status 
jobs characterize heavy drinkers. 

3) The exact number of alcoholics is 
estimated at 6.5 million in the 
1960's (V. Efron and M. KeUer, 
Selected Statistical Tables on the 
Consumption of Alcohol, 1850- 
1960, New Brunswick, N.J.: 
Rutgers Center of Alcohol 
Studies, 1963) which is regarded 
as too conservative. 

The National Council on Al- 
coholism estimated that in 1971, 
there were approximately 9 mil- 
lion alcoholics in the U.S. 



4) Donald J. Giese, "Report on 
Drinking," St. Paul Pioneer Press, 
May 25, 1969, observed that of 
the pedestrians killed in 1968 in 
Minnesota, 38 percent were 
tested, and 24 percent of those 
tested showed evidence of alco- 
hol. Half of the pedestrians 
tested were 65 or older. 

Alcoholics constitute about 3 per- 
cent of a work force (industrial, 
business and government). 

Types and Phases of Alcoholism 

The two categories of alcoholics as 
defined by the Alcoholism Subcom- 
mittee of the World Health Organiza- 
tion are "alcohol addicts" and "habit- 
ual symptomatic excessive drinkers" 
referred to as non-addictive alco- 
holics. Both are characterized by 
excessive drinking. But the former, 
after several years of excessive 
drinking, lose control while the latter 
do not (Jellinek, E.M., "The Disease 
Concept of ft Alcoholism," Hillhouse 
Press, I960). 

2. Drug Dependence 

The term "drug dependence," rather 
than "drug addiction," has been ac- 
cepted by the World Health Organiza- 
tion as well as by the National Re- 
search council of the National acade- 
my of Sciences. The WHO defines 
the term "drug dependence" as a 
"state of psychic or physical depen- 
dence, or both, on a drug arising in a 
person following administration of 
that drug on a periodic or continuous 
basis" (Nathan Eddy, H. Halback, Ing. 
Harris Isbel and Maurice H. Seevers, 
Drug Dependence: Its Significance 
and Characterist ics, Bulletin WHO 
(1965), Vol. 32). 



194 



Three kinds of drug dependence have 
been classified. These are: 

1) Narcotics 

2) Hallucinogens 

3) Amphetamines 

Narcotics 

Estimates of drug dependents are 
very difficult to make. However, 
when the New York City Department 
of Health undertook an intensive nar- 
cotics registration project, it was 
observed that about 1 in 80 persons in 
the city were addicted. Moreover, at 
Bellevue Hospital, it was found that 
for every chronic heroin user known 
to the police, at least one other was 
not. Hence, it was conservatively 
estimated in 1968 tiktt there were 
about 50,000 addicts in New York and 
about 100,000 nationally (Louria, 
Donaki B., The Drug Scene , McGraw 
Hill). On a CBS news broadcast on 
March 12, 1970, Dr. Stanley Yolles, 
former director of the National Insti- 
tute on Mental Health, was quoted as 
estimating that there are at least 
100,000 to 50,000 hard narcotic ad- 
dicts in the nation (U.S. Department 
of Health, Education and Welfare, 
Narcotic Drug Addiction , Mental 
Health Monograph No. 2, Bethesda, 
Maryland, 1965). 



Hallucinogens 

Estimates made by Louria about use 
of LSD stands at about 120,000 or 
less among college students, but none 
is known to be available for the rest 
of the population. Regarding the use 
of marijuana, a conservative Admin- 
istration Task Force estimated that 
at least 5 million Americans have 
used marijuana at least once. Dr. 
Stanley Yolles estimates that it has 



been used by at least 12 million, 
perhaps even as high as 20 million. 
But he also estimates that perhaps 65 
percent of these are merely casual 
pot smokers. 

Amphetamines 

No exact figures are available, but as 
with hallucinogens, there has been 
increased use of stimulants. The 
number of illicit users of ampheta- 
mines is estimated to be in the 
millions, most taking stimulant pills 
such as dexedrine, amphetamine, sul- 
phate, or methedrine and 
intravenously injected methampheta- 
mine, specially among the young 
(Martindale, Don and Edith Martin- 
dale, The Social Dimensions of Men- 
tal Illness, Alcoholism and Drug De- 
pendence , Glenwood Publishing 

Combining all three categories, a 
rough estimate of total number of 
drug dependents would range any- 
where from 5 to 10 million. 

3. Mental Illness 

During 1966, approximately 19 mil- 
lion (one out of ten) people suffered 
from mental or emotional illness that 
required treatment. About half a 
million children were mentally ill, 
most of them suffering from schizo- 
phrenia; very few of these children 
were receiving treatment. In the 
previous year, about 3.9 million A- 
mericans received treatment in pri- 
vate or public hospitals and clinics 
(Thomas S. Szasz, The Myth of Men- 
tal Illness: Foundations of a Theory 
of Personal,, Conduct , Harper and 
Row, 1968). 



195 



Approximately one-fourth of the 3.9 
million patients were treated by the 
state and county mental hospitals as 
well as by the Veterans Administra- 
tion Hospitals. For the state and 
county hospitals, it was noted that 
schizophrenic reactions, alcoholism 
disorders, and mental diseases associ- 
ated with the aged constituted the 
majority of first admissions (National 
Institute of Mental Health, Patients 
in Mental Institutions, II , 1965). A 
1972 sample survey of admissions to 
state and county hospitals by the 
NIMH provides a breakdown of .4 
million admissions by age, sex, color, 
and diagnosis. 

4. Affected Population 

An estimate of the population of 
alcoholics, drug dependents and men- 
tally disturbed around 1970, assuming 
mutual exclusiveness, can be obtained 
by adding estimates of the subgroups 
noted earlier. It is felt that such 
estimates would lie between 18 and 
23 million. 



196 




■IP 



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reaction time) 

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reaction time) 

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Walks w/ Special 
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Upper Extremities 

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Totals 



202 



<HJ.S. GOVERNMENT PRINTING OFFICE: 1 980 625-988/2062 1-3 




XI 


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FEDERALLY COORDINATED PROGRAM (FCP) OF HIGHWAY 
RESEARCH AND DEVELOPMENT 



The Offices of Research and Development (R&D) of 
the Federal Highway Administration (FHWA) are 
responsible for a broad program of staff and contract 
research and development and a Federal-aid 
program, conducted by or through the State highway 
transportation agencies, that includes the Highway 
Planning and Research (HP&R) program and the 
National Cooperative Highway Research Program 
(NCHRP) managed by the Transportation Research 
Board. The FCP is a carefully selected group of proj- 
ects that uses research and development resources to 
obtain timely solutions to urgent national highway 
engineering problems.* 

The diagonal double stripe on the cover of this report 
represents a highway and is color-coded to identify 
the FCP category that the report falls under. A red 
stripe is used for category 1, dark blue for category 2, 
light blue for category 3, brown for category 4, gray 
for category 5, green for categories 6 and 7, and an 
orange stripe identifies category 0. 

FCP Category Descriptions 

1. Improved Highway Design and Operation 
for Safety 

Safety R&D addresses problems associated with 
the responsibilities of the FHWA under the 
Highway Safety Act and includes investigation of 
appropriate design standards, roadside hardware, 
signing, and physical and scientific data for the 
formulation of improved safety regulations. 

2. Reduction of Traffic Congestion, and 
Improved Operational Efficiency 

Traffic R&D is concerned with increasing the 
operational efficiency of existing highways by 
advancing technology, by improving designs for 
existing as well as new facilities, and by balancing 
the demand-capacity relationship through traffic 
management techniques such as bus and carpool 
preferential treatment, motorist information, and 
rerouting of traffic. 

3. Environmental Considerations in Highway 
Design, Location, Construction, and Opera- 
tion 

Environmental R&D is directed toward identify- 
ing and evaluating highway elements that affect 

* The complete seven-volume official statement of the FCP is available from 
the National Technical Information Service, Springfield, Va. 22161. Single 
copies of the introductory volume are available without charge from Program 
Analysis (HRD-3), Offices of Research and Development, Federal Highway 
Administration, Washington, D.C. 20590. 



the quality of the human environment. The goals 
are reduction of adverse highway and traffic 
impacts, and protection and enhancement of the 
environment. 

Improved Materials Utilization and 
Durability 

Materials R&D is concerned with expanding the 
knowledge and technology of materials properties, 
using available natural materials, improving struc- 
tural foundation materials, recycling highway 
materials, converting industrial wastes into useful 
highway products, developing extender or 
substitute materials for those in short supply, and 
developing more rapid and reliable testing 
procedures. The goals are lower highway con- 
struction costs and extended maintenance-free 
operation. 

Improved Design to Reduce Costs, Extend 
Life Expectancy, and Insure Structural 
Safety 

Structural R&D is concerned with furthering the 
latest technological advances in structural and 
hydraulic designs, fabrication processes, and 
construction techniques to provide safe, efficient 
highways at reasonable costs. 

Improved Technology for Highway 
Construction 

This category is concerned with the research, 
development, and implementation of highway 
construction technology to increase productivity, 
reduce energy consumption, conserve dwindling 
resources, and reduce costs while improving the 
quality and methods of construction. 

Improved Technology for Highway 
Maintenance 

This category addresses problems in preserving 
the Nation's highways and includes activities in 
physical maintenance, traffic services, manage- 
ment, and equipment. The goal is to maximize 
operational efficiency and safety to the traveling 
public while conserving resources. 

Other New Studies 

This category, not included in the seven-volume 
official statement of the FCP, is concerned with 
HP&R and NCHRP studies not specifically related 
to FCP projects. These studies involve R&D 
support of other FHWA program office research. 



DOT LIBRARY 




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